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FROM October 1st, 2021

Authors: H.E. Toyin Ojora Saraki, Founder-President The Wellbeing Foundation Africa, Ms. Comfort Lamptey, UN Women Country Representative to Nigeria and ECOWAS, Dr. Roopa Dahtt, Executive Director Women in Global Health, Olabukunola "Buky" Williams, Executive Director of Education As A Vaccine, Dr. Adepeju Adeniran Co-chapter Lead, Women in Global Health Nigeria.
Note: This article was published on Royal African Society, African Arguments.
  61 years after Nigeria seized the reins of independence, October 1st is a day of national reflection. The task of nation-building is a lengthy and laborious endeavour and honest introspection of our collective gains and losses must be undertaken as we map our path forward towards the goal of shared peace and prosperity. Nigeria’s achievements in human-centred development are not in question. We have excelled and exceeded in a multitude of fields with legacies in business, sports, the arts and science etching the knobs and shifting the dials on the various indicators by which we measure national ‘success’. Yet these successes have an overriding common factor: They have been steered, achieved, and celebrated predominantly by male figures. Icons and heroines of the past such as activist, political campaigner, and founder of the Nigerian Women's Union, Funmilayo Ransome-Kuti, Margeret Ekpo, the pioneering female politician in the country's First Republic and the architect of modern pottery in Nigeria Ladi Dosei Kwali pushed open the doors of female inclusion and representation in the national space. In the male-dominated arena of finance eight women currently serve as Chief Executive Officers (CEOs) or Managing Directors (MDs) of the country’s leading banks. In the fields of human rights and social welfare, in which women remain the conscience of the nation, trailblazers such as Sadiya Umar Farouq continue to fight for increased intervention. On the global stage, Nigerian women continue to shine, with the World Trade Organization (WTO) being led by Dr Ngozi Okonjo-Iweala, the maverick former Nigerian Minister of Finance. The same level of global trust in the Nigerian women’s ability has witnessed the rise of Amina J. Mohammed as Deputy Secretary-General of the United Nations and Chair of the United Nations Sustainable Development Group, whilst in the field of literature Chimamanda Ngozi Adichie continues to keep the world spellbound, engaged and mesmerized. As global advocates of women’s rights, health and well-being, the calls for equity and equality in all sectors and especially in the health sector in the face of the COVID-19 pandemic, have risen from murmurs to bellows. Women represent 70 percent of the 43 million workers in the global health care industry yet occupy only 5% of leadership positions. Ninety percent of registered nurses globally are women, women remain the backbone of the informal workforce of unpaid caregivers of sick relatives, community members and children at home. Yet, their immense contribution does not only remain generally unacknowledged, a women’s effort is yet to translate to representation on policy and decision-making tables. Health is fundamental to national, as well as global security. A gender-balanced health sector leadership in any nation, deliberately ensuring inclusiveness, while eliminating structural inequities, will deliver the population health essential to reaching the national goals of development and progressiveness. Nigerian women in health have shown great fortitude and stellar results when present in the room.  Sign-post examples include women like late Dora Akunyili, whose immense work produced game-changing policies in the Nigerian national drug-supply chain, and the late Dr. Stella Adadevoh, whose foresight changed the trajectory of the Ebola pandemic in Nigeria in 2014, which as the most populous African nation, proved to be an essential pivotal moment in the global threat of Ebola. On a less national level, Nigerian women are at the fore-front of the health development programs, as they deliver life-saving health implementation activities of malaria prevention, nutrition and, water and sanitation, essentially as house-hold partners and implementers to the national health programs. In spite of these documented examples from the bottom and the ones at the top, the public health sector leadership in Nigeria is still male-dominated, and far too much work delivered by women is not credited to them; whereas women-driven civil society leadership such as the strong advocacy trajectory of Nigeria's Wellbeing Foundation Africa continue, consistently to deliver frontline impact and women-centred results. The Nigerian health sector stands to benefit from the immense talent and perspectives that a more gender-balanced leadership that an increase in female leadership will bring. Women in global health Nigeria, a chapter of Women in global Health, was founded in response to this, and its aims to ensure this balance. It connects the work of Nigerian women, from all levels of the life-course to ensure the inclusion of a gender lens in national policy development. Women in global health Nigeria ensures that more Nigerian women will contribute from the point of view of leadership in the national health discourse, and that Nigerian women in health will receive the commensurate credit for all their contribution to the health sector; by closing the pay-gap for female health workers, and amplifying the essential work that other levels of committed Nigerian women do. Leadership at the frontline must also cascade to the household where social protection systems and networks that address the risks towards women and provide support for those facing situations of vulnerability or crisis must be strengthened. They play a vital role in protecting women from poverty and insecurity whilst helping them to cope and recover from shocks ultimately leading to the change in a woman's outcomes. At the forefront of encouraging and inspiring transformative women leadership in all spheres is the African Women Leaders Network. The COVID-19 pandemic and its disproportionate gendered impacts have challenged AWLN to overcome the setbacks in their goal of creating a continent-wide force of women leaders who contribute to Africa's growth, progress and prosperity by advocating on imperative causes such as reproductive health, gender-based violence, the rights of women and gender equality. This can only be achieved by elevating the status of women’s leadership in Africa and passing on the knowledge learnt by these leaders to the next generation.   The assessment of global progress towards achieving gender equality, 25 years after the Beijing Conference on Women, reveals that gains have been slow and uneven and in some cases, significant pushbacks to this agenda persist. The area where most progress has been recorded is in the adoption of laws and policies to advance women’s rights. In this respect, Nigeria’s record aligns with that of most countries.   Nigeria scored highly with respect to having in place legal frameworks that promote, enforce and monitor gender equality, according to UN Women’s Gender-specific SDG indicators (Women Count). However, the greatest hurdle remains insufficient and proper implementation and follow-up.   Nigeria has continued to make gains in women’s active inclusion in social, economic, and political spheres- however more needs to be done. Recent data from UN Women’s Women Count Data Hub[1] indicate that in Nigeria, there is a 62% literacy rate of girls aged 15 years and above and growing concerns over the school retention and transition rates.  With all the gains made, it is crucial that gender-disaggregated data is available so as to enable effective gender programming and budgeting.   In 2020, UN Women spearheaded the ‘Generation Equality’ campaign, a global multi-stakeholder movement rallying civil society, government, activists and private sector to take bold actions as catalysts toward the vision of the Beijing Declaration and Platform for Action - an undisputable blueprint for a gender-equal world cosigned by women across the globe.   Gender equality is the unfinished business of each generation.   A key action of the movement in Nigeria was to facilitate intergenerational exchange between Nigerian women leaders who were present at the Beijing World Conference on Women in 1995 and today’s generation of Nigerian young women. Thanks to the 1995 generation, the Ministry of Women Affairs was born and because of the 2020 generation, women and girls issues continue to be placed at the forefront of Nigeria’s agenda.   This is the generation that tirelessly spotlighted the plight of sexual and gender-based violence in learning institutions and across leading to the declaration of a State of Emergency on GBV. This is the generation that has organised and mobilised civic action on important issues of democracy and governance.  In response to the State of Emergency, at least 23 states have now domesticated the Violence Against Person’s Prohibition (VAPP) Act compared to less than 10 in 2018. Already, ahead of the 2023 elections, youth are the highest constituency group already registering to vote and contest. Generation Equality recognizes the important roles of next generations in being changemakers and working together with gender equality advocates in their local communities - in raising awareness on gender equality with the goal of leaving no one behind.   Nigerian young women are the movers and shakers of political and civic leadership, culture and thought as well as entrepreneurship and innovation. To paraphrase the National Prayer, they are the generation that is ensuring the labours of Nigerian women heroes are not in vain. Concerted efforts must be made to ensure intentional intergenerational exchange to sustain the gains made since the Beijing Platform for Action.   It is time for the nation to embrace a leadership shift, through an enabling environment - from politics to business and society - that opens the space for young and old to have a transformative impact on our ability to make social change happen. [1] https://data.unwomen.org/country/nigeria

FROM September 24th, 2021

Building Resilience Through Actionable Hope – To Recover from COVID-19, Rebuild Sustainable Systems, Respond to the Needs of the Planet, Respect the Rights of People, Replenish And Redeem The Promise Of Multilateralism At The Frontline, And At Scale

 

Download Her Excellency Toyin Saraki Global Office and Philanthropy and The Wellbeing Foundation UNGA76 Advocacy And Activity Statement here: 

Keeping A Better World In View

The COVID-19 pandemic has proved to be the most challenging period the world, and the global health and development community has seen since the Second World War. It’s given way to the new disturbing normal – deepening inequalities and vulnerabilities, decimating economies and plunging millions into extreme poverty. Yet we all agree that the world must prioritize a sustainable recovery, rooted in the 2030 Agenda, and supporting countries and communities as we work to rebuild systems shattered by the pandemic. The backdrop to this year’s 76th UN General Assembly, UN Global Compact, and the important Concordia Leadership Council and Concordia Summit is a world that feels fractured — just when we need to come together against the continued ravages of COVID-19, the accelerating climate emergency, unfolding humanitarian disasters, rising inequality, and much more. Fixing it will take bold leadership, brave choices, and sustained commitments. At UNGA, it means bringing together world leaders, civil society champions, young people, global businesses and many others to reinforce and reinvigorate our collective determination to solve our shared problems.  

Bold steps towards improved community-centred care

  At the Wellbeing Foundation Africa, we have consistently honoured and expanded our central mission to make childbirth safer and reduce preventable deaths by deepening and knowledge-driven impact to community frontlines even as governments and multilateral agencies sought to strengthen health systems, deliver COVID-19 testing, treatment and equipment, and contribute to the most ambitious vaccination campaign in history.    Through the core platform at the heart of our frontline impact, the  multi-faceted institutionally endowed Mamacare360 Community Midwifery powered Antenatal and Postnatal Social and Health Education and Nursing Care Program, and to guarantee the progression of a healthy future towards attaining our Women Girls and Gender Development Targets, the WBFA has continued to promote respectful and comprehensive maternal, newborn, child and adolescent health, care, and combat both non-communicable diseases and neglected tropical diseases through improvements in nutrition, water, sanitation and hygiene practices. From the research bench to the health facility, household and hut in over 670 communities,  we are committed to improving competencies in clinical practice of health workers, creating an enabling environment for healthcare leaders and facility managers and enacting policy and programs that work for, and directly with, women, their newborns and their families. The Wellbeing Foundation Africa (WBFA) programmatic initiatives are targeted at remediating the weaknesses of health systems challenged by a myriad of issues from demand creation for health seeking orientation for social behavioural change to better supply chain management, diagnostics and treatment, all with reaching people, from conception and birth, to advanced age, and building sustainable cities to enable better health and wellbeing at the core.  Of all our programming across Nigeria, the 2 programs that were most prophetic of the skills and capacities needed to combat COVID-19 during the restrictions of socially distanced physical lockdowns, were our organic introduction of Mamacare360 and MaternalMonday Whatsapp Groups to continue the conversations in our Mamacare360 classes, and our WASH For Wellbeing program, teaching clean hygiene to mothers and medical workers in HCF, and its counterpart Primary and Adolescent PSHE-WASH in Schools. We had initiated these focused platforms in April 2018, as our responsive commitments to both the UN Secretary General’s call for improved WASH, the WHO Resolution on Hygiene in Health Care Facilities, and, our stark finding that only 22% of Delivery Rooms in Nigeria had direct access to a basin, soap, and clean water. As Covid-19 appeared, we were positioned in 670 communities, to ramp up the key learnings for social behavioral change, right in the communities and households, schools and marketplaces where trusted learning needed to reach. The WBFA continues in its quest to develop a concrete Nigeria-wide public health informed approach that looks at the contextual factors, and responds with key actions for individual women, children, their families and the schools and health facilities within their communities in which they live that make it more or less likely that vulnerability and adversity in childhood has a lasting impact on their lives. A holistic inclusive approach, that takes our community midwifery approach further into a school nurse-visitor information, education and learning approach, and a reporting index will address inequality and the broader causes of vulnerability which might otherwise be overlooked to support decision-making and prioritisation.  

Reaching the high-burden last mile

Our ongoing project with our global partner, Nutrition International has seen our program implementation model expand to Northern Nigeria where reported health indices represent the lowest and worst levels in the country. The WBFA ‘Scaling up Zinc and LO-ORS to Improve Childhood Diarrhoea Treatment’ programme which commenced in July 2021 in the two highest-burden of diarrheal disease localities, Kano State (the second most populous state in Nigeria after the megacity, Lagos) and Sokoto State - aims to redefine the health system services to sick children via improved availability and uptake of Zinc and low-osmolarity oral rehydration solution (LO-ORS) which are critical in the treatment of childhood diarrhoea. We advocate that Zinc reduces diarrhoea-specific mortality by 23% and LO-ORS decreases this mortality by an additional 84%3. For this reason, the World Health Organization recommends treatment with zinc and LO-ORS for the clinical management of acute diarrhea. Our objectives to improve the provision of appropriate information to caregivers and influencers, develop the capacity of and improve the supportive supervision for health workers, and the states to increase and sustain availability and access to zinc and LO- ORS commodities demonstrates our commitment to improving the survival rates and health outcomes of infants whose future should be protected. 

 

Building A Pipeline Of Skilled Health Workers

The WBFA is proud to have successfully concluded our ambitious 5-year collaboration with Johnson & Johnson Global Health and the Liverpool School of Tropical Medicine’s Centre For Maternal and Newborn Health, to improve the quality and availability of maternity, newborn and obstetric care in Kwara State, North Central Nigeria, by delivering a comprehensive skills-based and certificated training package for 62,800 multitiered professional health workers in Emergency Obstetric & Newborn Care (EmONC). The project was centred on improving maternal and neonatal health by building capacities of in-facility health care workers in basic and comprehensive emergency obstetrics and newborn care (BEmONC and CEmONC) respectively. The impact is clear, a 15% reduction in maternal mortality, and a 20% decrease in stillbirth rates by 20% - giving Kwara State the enviable ranking of the highest and best maternal, newborn and child survival rates in Nigeria, while partners await the initiation and implementation of the newly-introduced WHO guided perinatal birth and death audits. Upon conclusion the programme saw the growth of invaluable support to health solutions and improved  quality and availability of skilled birth attendants (SBA). Successes included the upgraded capacity in 27 healthcare facilities across 9 Local Government Areas (LGAs)  to provide quality EmONC. A total of 290 healthcare providers were trained in EmONC,  whilst the training  in quality improvement of 88 healthcare providers were conducted across all LGAs in Kwara State. 50 master trainers and skills lab coordinators were also trained and positioned to facilitate training and anatomical skills laboratory sessions on a regular basis. 11 skills labs were established and are being used on a regular basis by healthcare providers in the 16 LGAs.  The upgrading 21 facilities (100%), alongside the certification of two cluster Centres of Excellence for ongoing impact, and their improved availability of Emergency Obstetric Care services to their patients will have a lasting effect in combating maternal mortality in Kwara State - which we hope will extend to influence pre and post service qualification and regulatory curriculae across Nigeria on the whole, while lighting a path of an effective community of clinical practice for other states to replicate.    

Navigating COVID with a gender local-first lens periscope

  Reflecting on the General Assembly’s vital work in the areas of peace and security, disarmament, human rights, gender equality and sustainable development while also overseeing the adoption of major resolutions on key issues - from peacebuilding to counterterrorism and preventing crimes against humanity - addressing climate change and ending human trafficking, the WBFA, which enjoys special consultative status to the Economic and Social Council ECOSOC of the United Nations, and through its leadership of advocating for Nigeria’s ICPD25 commitments, and participation in both the African Womens Leadership Network (AWLN) and the UK-France PSVI Consultations in support of United Nations Resolution 1325 on Women Peace and Security, can affirm that the General Assembly has proven, time and again, the value of multilateralism and a rules-based international system to drive community-level action, and impact thereof. We live and work in unequal, challenging and ground-breaking times, and must seize strategic opportunities to transform the prevailing challenges to historic innovation - in order that progress will prevail productively for the last mile.  

Reinforcing and replenishing resources for impact

From the earliest moments of the last year of global, national and sub-national activity we knew that COVID-19 would dominate our agenda, yet we also braced ourselves to grapple with the challenge of significantly reduced global aid portfolios, by advocating strongly for increased domestic resource mobilisation as our long-standing collaborations and campaigns with multilateral agencies themselves seek greater investments to continue their essential work to ensure that unmet needs are met. Yet, because we have observed health-focused private sector industries grow huge profits from the pandemic, largely in provision of testing and tracing, some of which are mandatorily inclusive of government levies, we must call for greater accountability, philanthropy and corporate social responsibility support towards civil society organisations, upon whom the task of frontline mitigation has often fallen.   As Covid-19 variants continue to drive surges of outbreaks, democratising access to open-source and universally accessible reliable genomic surveillance capacities will help accelerate timely analysis and inform response measures to keep countries one step ahead of the virus and counter emerging threats in the future, using data insights to help community health workers and health facilities around the world contain any potential pandemic threat within 100 days of an outbreak.   We can’t achieve our goals on our own. We work together with businesses, government, research institutions and nonprofits, and each partner plays a specific role in accelerating progress. Covid-19 caught the world flat-footed. We must act now, before the next disease outbreak hits, to ensure that we have the data and information needed to respond quickly and prevent it from spreading. Inasmuch as we have reiterated our call that the world needs the WHO, this reinforces our belief that the world needs a more effective and more responsive UN, in a shift from focusing on procedures at the cost of substance to a more streamlined and inclusive priority driven agenda which prioritizes the perception of the UN family of agencies, of which the WBFA is honoured to enjoy close collaborations with the WHO, the PMNCH, the UNFPA, UNWomen and UNHCR, as an indivisibly integrated entity of respect, integrity and progress.

Rebuilding better for the most vulnerable: mothers, adolescents and newborns

In the busy months ahead, we will have to factor in a mitigation and growth strategy to drive and bring national and regional resilience to bear upon the difficult circumstances and effect of conflict and climate change; deepening poverty, exclusion and inequality; and a pandemic that continues to threaten lives, livelihoods and futures, particularly close to our programmatic frontline home in the African Union and ECOWAS regions. These challenges are worsened by the divisions scarring our world…between the rich and poor. between those nations who have the luxury of being able to take basic services for granted - and those of our nations for whom these essentials remain a distant dream. Towards ensuring that the benefit of our programs impact and reach even the most fragile and vulnerable citizens of concern, the WBFA has commenced a compassionate new science driven partnership - The Medela Cares and Wellbeing Foundation Africa (WBFA) ‘Lactation and Human Milk Initiative’. As an Every Woman Every Child commitment centred partnership, our collaboration is breaking new ground in influencing Neonatal And Intensive Care Unit Clinical and Healthcare policy in Nigeria on the importance of own mothers milk (OMM) to improve infant feeding and ultimately health outcomes. The initial 12 month quality improvement education program which commenced in January 2021 is specifically designed for mothers of, and the premature, fragile and sick infants in Neonatal Intensive Care Units (NICU), putting the latest in healthcare quality improvement technology into practice. Nigeria consistently ranks as a high-burden country for neonatal mortality, with over 371,000 babies being born prematurely annually, and with complications due to prematurity being the leading cause of death in children under 5. These complications cause >30% of neonatal mortalities (WHO child mortality reports). Additionally, these infants experience more morbidities and long-term complications. All of these negative aspects are significantly reduced with increased dose and exposure to own mother's milk (OMM). The Medela and WBFA project is a thorough and wide reaching initiative currently running in four facilities in three states in Nigeria, Lagos, Abuja and Kwara. Through this NICU quality improvement intervention, Medela Cares and WBFA  will upskill and enhance lactation and human milk knowledge, skills and expertise for NICU, maternity and affiliated health care professionals. The project will drive the much required change from a facility, policy and health systems management level on the importance of lactation and human milk to reduce the indices of neonatal mortality   

Future forward: equality, equity and fairness

  It is no coincidence that the start of this year’s General Assembly was immediately preceded by World Equal Pay Day, as we focus on Building resilience: The Future of Protecting Global Health, and the role of health workers in responding to COVID-19 and delivering essential services, yet in so many countries, the female health workforce cannot celebrate equal pay for work of equal value or build upon the United Nations and ILO commitments to human rights and against all forms of discrimination, including discrimination against women and girls.   Globalization, digital innovation and climate change, among other factors, continue to change the world in which we work — posing both challenges as well as opportunities in realizing women’s economic potential for a better tomorrow. Across all regions, women are paid less than men, with the gender pay gap estimated at 23 per cent globally. Gender equality and the empowerment of women and girls continues to be held back owing to the persistence of historical and structural unequal power relations between women and men, poverty and inequalities and disadvantages in access to resources and opportunities that limit women’s and girls’ capabilities. Progress on narrowing that gap has been slow. While equal pay for men and women has been widely endorsed, applying it in practice has been difficult. The Wellbeing Foundation Africa had made strategic early investments in a female centred frontline health workforce, with our midwives, nurses, doctors and coaches serving as dedicated community educators and interlocutors, proving time and time again, with unstinting dedication that an educated, empowered, equipped and equally remunerated female health professional can deliver a five-fold demographic dividend, for herself, her family, her patient, her health facility, and her community.   In order to ensure that no one is left behind, throughout UNGA76 and beyond, we must amplify the Sustainable Development Goals (SDGs) that address the need to achieve gender equality and the empowerment of all women and girls, promote decent work and economic growth by seeking full and productive education, employment and decent work for all women and men, including for young people and persons with disabilities, and equal pay for work of equal value, thus mainstreaming the gender perspective as being crucial in the implementation of the 2030 Agenda for Sustainable Development with specific focus on the labour force, unemployment, occupational segregation, the gender wage gap, unpaid work, parental leave, informal work, migrant workers, violence against women, legal barriers, social protections and the digital divide.   Achieving equal pay is an important milestone for human rights and gender equality. It will take the effort of the entire world community and more work remains to be done to promote equal pay for work of equal value and the economic empowerment of women and girls.The journey forward: Impatient Optimism towards sustainable cities and systems for safer births - a more equal and equitable multi-lateral paradigm towards a healthy future for all The pandemic is upending health systems and health workforces around the world—and threatening to reverse decades of progress in global health. That’s why the Wellbeing Foundation Africa, a member of the UN Global Compact, is joining Reckitt, and many other private sector and socially responsible corporate allies and businesses to fight poverty, addressing social determinants towards a better future in actionable hope.  As supporters of WHO standards and targets, the WBFA is committed to the targets of the Frontline Health Workers Coalition in advocating for immediate investments and policy changes to support and protect the frontline health workforce, particularly in low- and middle-income countries.   We must underscore the need to speed-up our response to COVID-19, with vaccines, treatment and equipment for all; to invest in human development, health care, nutrition, water and education; and also commit, and look forward, to both the bold targets for displaced and refugee communities in October, and making progressive contributions to climate targets at the COP26 UN climate conference. My leadership of the Wellbeing Foundation Africa’s mission is filled with impatient optimism that today’s actions will have an immediate impact. They will also shape our collective tomorrow. Half the world is under 30, another 10 billion will be born this century. They should benefit from the peace and prosperity, the global equity and sustainability that the Sustainable Development Goals could bring.   Throughout the UNGA76 sessions, I have continued to advocate for recognition and respect for local and frontline organisational capacities with regards to global partnerships, in order to ensure equitable funding practices and donor-grantee relationships.   In order to ensure true equity across the sector, donors and grantees need to unite in their shared values and ambitions, to combine the donor’s resources with the grantee’s on-the-ground knowledge of how these can be translated into tangible changes - to ultimately strive for equality, and true accountability as a united front.   Nowhere have inequities been thrown into higher relief as in the war to contain, control and combat the coronavirus pandemic; Safe and effective COVID-19 vaccines were developed in record time. But the virus is moving faster than the global distribution of vaccines. The vast majority have been administered in high- and upper-middle-income countries, mostly in 10 countries alone. If these doses had been distributed equitably, they would have been enough to cover all health workers and older people globally.   The global failure to share vaccines equitably is taking its toll on some of the world’s poorest and most vulnerable people. New variants of concern mean that the risks of infection have increased in all countries for people who are not yet protected by vaccination. There are enough doses of vaccines globally to drive down transmission and save many lives, if they go to the people who need them most around the world. Worldwide access to COVID-19 vaccines offers the best hope for slowing the coronavirus pandemic, saving lives, and securing a global economic recovery.   To stop the pandemic, and to achieve vaccine equity, we need to vaccinate at least 70% of people in every country, and work towards integrating COVID vaccination campaigns within routine immunisation strategies.   Believing that it is only by constant replenishment and reinforcement that we can harness the crucial resilience to respond to critical points of crisis, the Wellbeing Foundation Africa’s  mission to strengthen the primary health care tier with a visionary new paradigm of universally accessible and affordable comprehensive community care, will see our Wellbeing Apex partnership birth a network of quality universal health coverage targeted facilities, driven by prompt diagnostics and efficient supply chain management, at scale, deliver family health services across communities - powered by concrete investments in generating more professional health workers to address the health worker - patient ratio. Our informed, intentional and deliberate optimism isn’t a belief that things will automatically get better; it’s a conviction that we can make things better. Creating that better future for all, by improving access and availability to health services, and empowering effective agency and autonomy from conception and birth, to advanced age, is in our hands.  

Building Resilience Through Actionable Hope – To Recover from COVID-19, Rebuild Sustainable Systems, Respond to the Needs of the Planet, Respect the Rights of People, Replenish And Redeem The Promise Of Multilateralism At The Frontline, And At Scale

  The war against inequities, poverty and injustice on our planet must succeed - These challenges and divisions are not an invisible intangible force of nature. They are (hu)man-made and require human solutions of redemption.   In the midst of hunger and crisis, the 2021 United Nations Food System Summit has convened global constituencies, world leaders and heads of state to engage deeply in the process of developing an initial set of country and multi-stakeholder commitments to action. These commitments are emerging to take forward the agenda to accelerate action to transform food systems to achieve the 2030 Agenda for Sustainable Development. We are less than a decade away from our shared target to bring greater safety, equity, and sustainability to our food systems that affect every area of our communal lives - our culture, our economy, and our health. We have a map to a resilient and sustainable and a healthy future for all but it is by harvesting our ambition, growing our seeds of change, and transforming the fruits of our dedicated labor - as change-makers, policy-makers and decision-makers - that we can ensure the future that we want. The same can be said for one of the darkest fights in the history of the human race: the war to eradicate racism and discrimination which continues to permeate institutions, social structures and everyday life in every society. 20th years after the Durban Declaration and Programme of Action (DDPA), Heads of States and Governments have gathered in the General Assembly hall as part of UNGA76, to discuss reparations, racial justice and equality for people of African descent. Structural racism and systematic injustice still deny people their fundamental human rights, and linkages between racism and gender inequality are unmistakable. As we re-commit to redeeming and replenishing the promise of multilateralism, matching the UN values of human rights at our last-mile frontlines, supporting the most vulnerable, peace through dialogue, action and solidarity with shared values. Over the next year, every day, we will keep this better world in view, living, working and breathing our central values during UNGA76, and across our world.
Download Her Excellency Toyin Saraki Global Office and Philanthropy and The Wellbeing Foundation UNGA76 Advocacy And Activity Statement here: Keeping A Better World In View

FROM September 6th, 2021

[embed]https://youtu.be/fN7y4KEglIg[/embed] Earlier this week I spent precious time #withRefugees at the UNHCR Nigeria supported UNHCR Refugees settlement communities in Ogoja, Cross Rivers State.  My first stop was Adagom where I was cheerfully welcomed by over 67,000 mothers, men and children once forced to flee, now residing in the Refugee Resettlement Community. Followed by an insightful discussion with the Women Leaders of both the refugee and wonderfully kind Adagom host communities. Adagom is a community full of vibrance and resilience but like so many other displaced communities, burdened with a lack of resources and basic provisions in health, education, and access to gainful livelihoods.  [gallery link="none" size="large" ids="1570,1571,1569"] I am pleased that my Wellbeing Foundation Africa team, National Program Coordinator and Lead WBFA Community Midwife were on hand to deliver food boxes, dignity kits, education learning materials, and undertake our WBFA baseline needs assessment. We demonstrated our flagship MamaCare class, whilst imparting successful breastfeeding practices with the assistance of WBFA manuals and IEC material.  There are more displaced peoples in Nigeria—over two million—than the populations of Equatorial Guinea, Seychelles and Cape Verde, combined. COVID-19 has affected such communities disproportionately, most especially the women and girls therein in need of maternal health support and timely antenatal care. We have to act fast to get these settlement communities back on track and ensure no woman, no expectant mother, no girl child is left behind.  [gallery size="large" ids="1572,1573,1574"] These numbers within the global 82 million refugees globally often fail to tell the full story of the tragic situation that has befallen so many residing in Nigeria's North East, and Cross River, Benue, Taraba, and Akwa Ibom States. The scale of this situation in Nigeria will be a tragedy for our people and our economy if we fail to plan, provide and act, for on their behalf. They are our own brothers and sisters for whom we have shared responsibility to support and include in our existing programmes. That's why I joined hands with UNHCR, UNHCR Nigeria, and UNHCR Private Sector Partnerships who support such vulnerable communities across the continent and the world by protecting and empowering displace men, women, and youth and to promote social inclusion and foster good relationships with their local communities.  The time is now to convene and inspire others towards action. I echo the words of the UN High Commissioner For Refugees that “solutions require global leaders and those with influence to put aside their differences, end an egoistic approach to politics, and instead focus on preventing and solving conflict and ensuring respect for human rights".The biggest achievement derived from the 1951 Geneva Convention itself, is that many of the challenges faced by IDP and Refugees are now categorised as international problems. In the same vein, individuals must remain exactly that - individuals; affording them a truly localised and personal approach to reintegration and community-level support. In doing so, we manage traumas correctly, minimise further displacement and ensure that all policies and societal practices reflect each citizen - by birth, heritage or displacement - right up until the last mile. I am encouraged by the learnings that private sector philanthropies and civil society can contribute in this journey, through collaborative efforts, to rethink and re-imagine the possibilities of donorship and of timely life-saving interventions for the millions of refugees and we must remember: no one is truly safe until everyone is safe.  I am pleased to join UNHCR, partnering to ensure all refugees and displaced people have access to their basic human rights and dignities.

FROM August 13th, 2021

This is a moment for heightened urgency in addressing the investments and attention being paid to our public health systems in Nigeria, as globally. Deep inequities and unbalanced approaches to channelling much needed remuneration, respect and investments to prioritise our frontline force have been exaggerated since the onset of the Pandemic. The unnerving, recent announcement by Nigeria’s National Association of Resident Doctors public strike is the fourth work stoppage by medical residents since the pandemic began. As the backbone of our public health - health and care workers and CHWs have provided essential health services to communities with the least access to quality care, especially in remote and rural areas- accelerating the attainment of universal health coverage - despite inadequate attention being applied to facilitating decent work, safety, dignity, fair pay and equal leadership they deserve - as the key mutual and multi-directional duty of care. I remain deeply concerned especially that the state of primary healthcare centres across Nigeria, and how the frontline potential for PHC's being the first port of call for serious injury and disease, a barrier between life and death for many - is being underutilized. For years, Nigeria, like many other lower-middle income countries, has struggled to address health worker shortage lagging far behind the WHO suggested doctor-patient ratio of 1:600. With the 19,000 protesting medical residents making up the bulk of health care workers at government hospitals throughout Nigeria, also staffing the majority of the government-run treatment facilities for COVID-19 - their absence at this crucial time is an alarming concern. This is a period that calls for whole system support as a duty of care - and a greater push for resources, resilience, replenishment towards recommended ratios which of course integrates regular remunerations. Taking learnings from paradigm shifts recorded in countries such as India, whose medical education system has been able to pull through a major turnaround, successfully doubling the numbers of MBBS graduate (modern medicine training) positions during recent decades - it is not enough to fixate on the excuse of doctor scarcity. As we move forward there is an urgent need to focus on augmenting the fiscal capacity as well as developing much needed infrastructure both in public and private health sectors toward addressing pressing healthcare needs of our growing population.

FROM June 23rd, 2021

COVID-19 has enabled global citizens to hold a greater understanding of the integral role WASH plays in public health, and our lives at large. It has caused policymakers, advocates and donor to review a culture that previously undermined the relationship we all had with WASH and disease prevalence. The current data sadly shows that Nigeria carries over 20% of our African continent’s NTD burden.

    • Over 134 million Nigerians need treatment for at least one of the five most common NTDs
    • Over 25 million Nigerians need treatment for schistosomiasis
    • Over 45 million Nigerians need treatment for soil-transmitted helminths
Unacceptable WASH and open defecation conditions not only fan the flames of COVID-19 to the point where people cannot adequately wash their hands, but also contribute to many lesser known but pervasive diseases that cause long-term effects on health, like NTDs. Today, as I welcomed a renewed focus directed at  'Breaking the Cycle of Neglect’ with The End Fund and The Economist Intelligence Unit, myself and other leaders advocated to explore the far-reaching impact of a worm-free world. The focus is very often solely on preventing mortality - and rightly so. But as we work towards changing the cultural and societal behaviours and commitments - or the lack of - towards WASH and the prevalence of NTDs, we need to take a closer look at the effects that NTD has on morbidity, too. Building a better community of practice for a worm free world through infection and infestation prevention and control is essential to maintaining good health and wellbeing for all. Diseases such as Schistosomiasis, STH and Parasitic Worms, can and must be recognised early and treated effectively - without cost, access or literary competency posing as a barrier. to patients. Dr. Alicia White's contributions and the research produced by EIU spotlights the macro-economic impact of ending sickness from parasitic worms in four sub-Saharan countries - notably illustrating that treatment and prevention of parasitic worm infections is transformative - not only for individuals and communities, but can lead to significant economic productivity gains for entire nations. [video width="1920" height="1080" mp4="https://toyinsaraki.org/wp-content/uploads/2021/07/WhatsApp-Video-2021-07-01-at-18.02.35.mp4" poster="https://toyinsaraki.org/wp-content/uploads/2021/07/Image-01-07-2021-at-18.20.jpg" loop="true" autoplay="true"][/video]   In my keynote address, I emphasised that diseases such as Schistosomiasis, STH and Parasitic Worms, can and must be recognised early and treated effectively - without cost, access or literary competency posing as a barrier to patients. As we hone in on the WHO targets for parasitic worms in particular, we must all welcome the renewed evidence for action delivered within the EIU report as a timely reminder that we must remain focused on the core constructs that embody and will soon enable the actualisation of the word ‘end,’ by way of control, elimination of transmission, elimination as a public health problem, and thus, total, long-term eradication. I believe and continue to demonstrate through my Wellbeing Foundation Africa's WASH program and outreach, that the solution for combating NTDs starts and ends with WASH – a message that the onset of the global pandemic successfully communicated to members of the NTD community, our global infrastructures, households and public service facilitators. As we hone in on the WHO targets for parasitic worms in particular, we must all welcome the renewed evidence for action delivered within the EIE report as a timely reminder that we must remain focused on the core constructs that embody and will soon enable the actualisation of the word ‘end,’ by way of control, elimination of transmission, elimination as a public health problem, and thus, total, long-term eradication. I believe and continue to demonstrate through my Wellbeing Foundation Africa's WASH program and outreach, that the solution for combating NTDs starts and ends with WASH – a message that the onset of the global pandemic successfully communicated to members of the NTD community, our global infrastructures, households and public service facilitators. The pandemic has caused policymakers, global health advocates and donors to step away from a culture that previously undermined the relationship between WASH and disease prevalence. A central goal of The Wellbeing Foundation Africa, is to improve health outcomes for women, children, and infants. We are committed to improving and increasing access to WASH in healthcare facilities, schools and communities across Nigeria, in a bid to reduce and eventually eradicate the prevalence of NTDs.  The WBFA has come a long way from establishing a private sector partnership in 2005 to promote peer-educator mass-action deworming clubs in schools, so we know that local NTD efforts have been around for many years, using a decentralized approach to treat communities. The Nigerian government launched a national plan in 2012 and devoted more domestic financing to simple deworming campaigns which the Wellbeing Foundation Africa believes should receive continuous replenishment and reinforcement to achieve universal community coverage. We must incorporate WASH into a holistic strategy, if we want to finally end neglected tropical diseases, and integrate our solutions for combating and ending NTDs, to start with improved water, sanitation and hygiene - WASH.Soil-transmitted helminths, schistosomiasis and other parasitic worm infections must be recognised early & treated effectively while improving access to detection strategies in houesholds, healthcare facilities,schools. Today, the clean hands of WBFA Mamacare360’s team of community centred midwives, in partnership with Unilever Lifebuoy Nigeria and Sight-savers, have the ambitious target of reaching more than two million children at-risk of NTDs, all while improving personal social and health education and hygiene practices for teachers, pupils and their families.  These school-based demand creation efforts reinforce, in children, their families, households and communities the importance of prioritising WASH interventions, including hand-washing with soap, to deliver a key, and continued driver of behavioral change. As we build back better, and continue to devise strategic contributions to a global Covid-19 response, the focus must continue to shift from solely categorising treatment as the primary solution, and begin to recognise, that with the magnitude of suffering caused by NTDs, the most effective and far reaching approach will be to simultaneously actualise prevention and the education we all need going forward. To #EndTheNeglect once and for all, we must continue to centre our understanding of the integral role WASH plays in public health, and our lives at large.

FROM June 10th, 2021

ERELU BOBAJIRO OF IRU LAND TRADITIONAL IWUYE CEREMONY & THE PRINCESS ROYAL OF IJORA KINGDOM AND IGANMU LANDS HOMECOMING APESIN PROCESSION Bearing the regal approval and presence of His Royal Majesty, Oba (Dr.) Abdulfatah Aremu Oyeyinka Aromire, Oyegbemi II, The Ojora of Ijora Kingdom and Iganmu Lands, I appreciate the honour bestowed upon me by His Royal Majesty, Oba Abdulwasiu Omogbolahan Lawal, Abisogun II, The Oniru of Iru Land, who conferred my humble self with the recognition of being appointed and installed as the Erelu Bobajiro of Iru Land on 10th June, 2021, during the week long 1st Year Coronation Anniversary Celebration of His Royal Majesty Abisogun II, Oniru of Iru Land. I congratulate Kabiyesi Oba Omogbolahan Lawal on the first anniversary of his coronation, and all chieftaincy honorees dedicated to the visionary mission to bring meaningful progress and development to Iru Land, supported by the Iru Land Oba-In-Council Cabinet of Chiefs. I am grateful for the inestimable love and support of my Royal Father, The Ojora of Ijora Kingdom and Iganmu Lands, Kabiyesi, His Royal Majesty, Oba (Dr) Abdulfatah Aremu Oyeyinka Aromire, Oyegbemi II, His Council of Chiefs, and the good people of the Ijora Kingdom and Iganmu Lands for honoring my homecoming to Ijora Oloye with the highest privilege of Apesin Ceremonial Procession. I equally congratulate His Royal Majesty, Oba (Dr) Abdulfatah Aromire, Oyegbemi II, Apasa Kekeniju, on the 27th Anniversary of his purposeful and successful continued reign as The Ojora of Ijora Kingdom and Iganmu Lands. I am appreciative of the amity, kinship and prayers bestowed towards me by Royal Stools and Royal Families across the length and breadth of Nigeria and beyond, most notably and especially, the gracious presence of Their Royal Majesties, The Amanyanabo Ebitimi Banigo, King of Okpoama Kingdom, Brass, Bayelsa State, his lovely Queen Pelebo Banigo, and their Royal Cabinet. I also appreciate the presence of The Erelu Kuti IV, HRH Princess Abiola Dosunmu, and the attendance of the Ilorin Emirate Princes, personally and as the delegated envoys of His Royal Majesty, The Emir of Ilorin, Mai Martaba, Dr. Ibrahim Sulu Gambari CFR. I recognize and appreciate the presence and attendance of Their Excellencies, Former Governors, Senator Liyel Imoke of Cross River State, Dr Abdulfatah Ahmed of Kwara State, Alhaji Shaba Lafiaji of Kwara State, Chief Olusegun Osoba and Beere 'Derin Osoba of Ogun State, Alhaji Ibrahim Hassan Dankwambo of Gombe State, current and former Distinguished Senators, Honorable Members of the House of Representatives and State House of  Assembly, current and former Honorable Ministers, current and former States Commissioners and Local Government Functionaries, national and states political parties functionaries and members, and the supportive presence of women and youth leaders, groups, cooperatives and associations. I am forever thankful for the unflinching and loving support and encouragement of my dear husband, His Excellency, Dr Abubakar Bukola Saraki, MBBS, CON, The Waziri Ngeri of Ilorin Emirate,13th President of the Senate and Chair, 8th Session of the National Assembly 2015~2019, together with the blessings of my lovingly respected parents, Their Royal Highnesses, The Otunba Adekunle Ojora OFR, CON, and The Erelu Odu’a Ojuolape Ojora, MON. I appreciate too, the personal visit, recognition and kinship of His Imperial Majesty, Alaiyeluwa, Arole Oodua, Olofin Adimula,The Ooni of Ife, Dr. Adeyeye Enitan Babatunde Ogunwusi, Ojaja II. With utmost respect and gratitude, I appreciate the attendance of my personal friends, international development and private sector partners, my immediate and extended family, and the good citizens of both Lagos and Kwara States. who honoured me with the joy and privilege of their distinguished presence at the Traditional Iwuye Ceremony at The Oniru’s Palace, Iru Land, and the Ijora Oloye Homecoming Apesin Procession at The Ojora of Ijora Palace, Ijora Kingdom. I pray for the light of knowledge, wisdom and peace for all, and journey mercies to our respective homes. Amen.

FROM May 31st, 2021

[embed]https://www.youtube.com/watch?v=aK6FtsOnKJw[/embed] I am delighted to join our partners, the Liverpool of Tropical Medicine, Johnson and Johnson Global Health, the Kwara State Government and all stakeholders today as we disseminate the results and impact of our 5-year program to improve the availability and quality of maternal newborn care services delivered by health workers in Kwara State. From the first moment I witnessed the impact of hands-on anatomically delivered simulation model training globally, I knew that building a community of well-practiced multi-disciplinary delivery teams could address the local frontline barriers to improving care services rapidly and whole-heartedly, at both the health system and societal level, in Nigeria. Thus, in 2015, my WBFA leapt at the golden opportunity to partner together with the Liverpool School of Tropical Medicine, CMNH-LSTM Nigeria and Johnson and Johnson Global Health to up-skill health care practitioners in the area of certificated Emergency Obstetric Care Skills and Drills. The main drive of the project pioneered across Kwara State, Nigeria, was to equip doctors, nurses and midwives so as to recalibrate a collective team and introduce the skills needed to overcome these obstetric emergencies. With hopes to improve maternal health significantly, we have continued to identify and lift away the barriers that limit access, availability and quality of maternal and newborn health services.  80% of all maternal deaths are as a result of five complications; all of which can- be managed by adequately trained healthcare professionals.  Haemorrhages, sepsis, eclampsia, complications of abortion and obstructed labour are among the common attributional factors of maternal and neonatal complications, but they also contribute to mortality and morbidity, too.  The introduction of specialist professional and regular training acts presents as a form of diligence while reinvigorating frontline workforce autonomy.  As we focused our intervention on local government areas within the state with the largest population of women of reproductive age, we landed in Kwara located in north-central Nigeria, It’s 3 million inhabitants and an estimated 120,000 births per year, coupled with my own personal state-centred nostalgia and birth experience, made it the perfect beginning for such a dissemination of key skills and learning. Through a partnership with the Liverpool School of Tropical Medicine and with support from Johnson and Johnson Corporate Citizenship Trust, Wellbeing Foundation Africa implemented a project to increase the availability and quality of care for mothers and babies at public and private healthcare facilities in Kwara State, Nigeria. Having sustained the early and encouraging impact being made by the introduction of EmONC skills and drills training, and expanding the program in 2018, we continued by paying joint advocacy visits to the Kwara State House of Assembly to advocate at the sub-national level for the training espoused by our EmONC program which was pioneering sustainable change across 21 public HCFs in the state. I hope that our strong evidence now demonstrates that anatomical models based skills and drills training must be recognised as a professional education curriculum requirement, and fast. As we conclude the 5th year of this pioneering introduction in Kwara State, we now have convincing proof of a concept beyond suitable for whole nation deployment. The results are clear, we’ve recorded a 38% reduction in facility stillbirth rate since 2015, and we know that the improvements and upskilling in Kwara can, must and will inspire change across the country. I thank our partners, the Liverpool School of Tropical Medicine’s Centre For Maternal and Newborn Health, and Johnson and Johnson Global Health, for the trust and confidence invested in the Wellbeing Foundation Africa and United Nations Every Woman Every Child Commitments to the Global Strategy on Women and Childrens’ Health, which powered our partnership, and their arrival to Nigeria to implement such a significant program. I beam with pride and with a grateful heart at the readiness demonstrated by a robust frontline, and look forward to the actualisation of a continuum of care that will contribute to the total zeroing of maternal and neonatal deaths in Nigeria.  It is often said that the true test of innovation and impact is sustainable local engagement, so I am delighted that the partnership was able to establish skills laboratories and centres of excellence at selected facilities. I congratulate our partners and the National Council of Nursing and Midwifery as the program impact progresses, again supported by Johnson and Johnson Global Health, on the strategic and intentional path towards national pre-service training scale. Towards holistically aligning and guaranteeing mothers access to higher quality respectful maternity care, the Wellbeing Foundation Africa continues to strengthen, deepen and widen its independent community midwifery-led Mamacare Antenatal and Postnatal Education Program, educating expectant and nursing mothers, ensuring they access and achieve the WHO recommended 8-visits throughout their childbirth journey - with the confidence of knowing that their professionally qualified delivery attendants are upskilled to deliver a safe, healthy and therefore happy outcome. We must continue on the quest to lift and leap over barriers, to deliver new life safely, and ultimately save millions more lives. Thank you all. [embed]https://www.youtube.com/watch?v=bhMUE5VZMZc[/embed]

FROM May 5th, 2021

2021 International Day of The Midwife: Follow the Data

The year 2020 was indeed a year of many unprecedented firsts, including the very first International Year Of The Nurse and Midwife, bringing long aspired recognition to the caring professions of nursing and midwifery, and the support systems that uphold their professional frameworks, which I was delighted to celebrate as the Inaugural Global Goodwill Ambassador for the International Confederation of Midwives, and as a longstanding supporter of the National Association of Nigerian Nurses and Midwives.. Reflecting on the many challenges that arose last year, and remembering with fondness, the lives affected and tragically lost, today we recognise, celebrate and signpost the formidable work my Wellbeing Foundation Africa Midwives and Midwives worldwide, have committed to - particularly as the ‘new normal’ continues to evolve. We have powered through with determination in the face of the coronavirus pandemic, and arrived at a full circle moment far different to past observations of days of commemoration, particularly in marking the simultaneous intersection of the International Day of The Midwife with World Hygiene Day For Healthworkers, in the fully reinforced knowledge that every midwife and health worker, everywhere, requires effective hand hygiene at the point of care, now more than ever. According to the WHO, the total health workforce in Africa currently stands at 1,640.000 people, of which, health service providers (doctors, nurses, midwives, laboratory technicians and community healthcare workers make up 1,360,000, of the workforce.)  While my global advocacy has amplified the importance of access to clean water sanitation and hygiene in health care facilities as being of equal importance to Personal Health Records and Vaccine Scheduling as just one of many examples of contributions to national data collection, the road to innovation which has been extensively re-mapped under the pressure of last year has proven that the resilience from adapted solutions and ways of working, recording and capturing data must continue to emerge.  Healthcare systems across the world have scrambled to draw workers from many units in order to assist with the pandemic and losing so many in the process, the importance of the professional and specialist midwife has been highlighted as essential to maintaining the gains made in other areas of healthcare service delivery outside of the pandemic. 2020 saw every citizen develop and demonstrate a sense of global sensitivity as we journeyed through a myriad of feelings. On the side of promise and positivity, a number of people took the time to delve deeper; in their homes, work teams and personal spaces, and in doing so, not only proved a sense of tenacity, committed to being recorded as a surviving number. We have recorded fluctuating virus contraction rates across nations, and amidst the pain and unpredictably unprecedented chaos and strain that Community Health Workers, Health and Care Facility staff and Healthcare Infrastructures have been under worldwide, our ability to recognise areas of neglect, advocate for increased remuneration and push for more essential PPE was largely due to commitments to collaboration - a collaboration which provided every nation with the numbers needed to move the world further forward, while identifying all those who truly helped to keep the world going round. Each strong national, regional, and global platform and partnership the Wellbeing Foundation Africa implements and amplifies has been maintained with UN EWEC, WHO, Global Water 2020, UNFPA, LSTM, JNJ, Laerdal Global Health, Global Affairs Canada, Nutrition International and Alive and Thrive to name a few, continuing to provide solutions by way of revised advocacy, policy and actions on key issues surrounding RMNCAH, Nutrition, Water and Sanitation Hygiene, Primary and Adolescent Health Education, SRH and gender equality, leading the line to achieve 8 of the 17 SDGs in sub-Saharan Africa - despite a global pandemic. At each juncture, our midwives have committed to the completion of each cause and the delivery of a continuity of care in an attempt to stabilise every cradle, in every community they reach. We have seen continued to witness the unmatched application of skills acquired in seasons past, as our frontline interlocutors lend their voice, hands and hearts to women and families across Nigeria, making it a pertinent point to reach the very last mile and make antenatal, intrapartum and postnatal care truly equitable and alive via our bustling WhatsApp communities. We’ve continued to see a near zeroing rate of Obstetric Emergencies in WBFA’s flagship EmONC training state of Kwara, in spite of economic, social and emotional challenges. Across the nation, from Lagos to Oshogbo, Ilorin, Kaduna, Abuja, Lafia and more, our Mamacare Program mothers, newborns and children have been equipped, empowered and invigorated at every juncture. Understanding that providing critical skills and support for women and children are fundamental solutions to improving health outcomes in Nigeria, and the onset of the Covid-19 pandemic has only heightened this priority.  My WBFA has remained in close convening with key stakeholders in the public, private and third sectors, to promote greater investment and shine a light on the efforts and contributions to ensure comprehensive access to primary healthcare at the community frontline, consolidating home-based health records and supporting maternal and child health handbooks, leading on Nigeria’s Primary Healthcare Revitalisation Support Group (PHCRSG), a coalition of over 70 NGOs and  CSOs, including development partners like multilaterals and bilaterals, and mobilising the global water community to applaud midwives and nurses with WASH. Such convenings and the content and progress thereof, is only possible when there is data-driven evidence available - made available by the physical number of staff on the frontline.  We must continue to have every midwife in mind when discussions surrounding methods and pathways to achieving true resilience, remunerating fairly and up-skilling accordingly are being had. The number of them will determine the number of us in years to come. This year, the ICM’s theme of Follow the Data: Invest in Midwives, depicts duality and a future of well-deserved possibilities for midwives worldwide. As facilitators called to nurture, care, birth and rear, midwives put the ‘front’ in frontline and count kicks and record the progress of every woman and her anticipated neonate(s) while doing so. I lend my voice as a contribution to the heightened respect that data has received in this season, and celebrate every Midwife - trainee and qualified - who has contributed to the numbers in position and in their daily protocol.  Now the journey continues, to support their resilience further by creating appropriate methods for reporting and capturing data, and in the context of heightened risks of racial inequities, I am delighted to welcome partners that have risen to the challenge of resource mobilisation to promote research and development towards racial equality across all areas of reproductive medicine and maternal health. The Ferring Innovation Grants Programme for Racial Equality in Reproductive Medicine and Maternal Health is focused on reducing racial disparities in maternal mortality and improving in vitro fertilisation (IVF), pregnancy and postpartum outcomes for Black communities, Indigenous communities and all communities of colour, to deepen understanding and, ultimately, drive solutions to tackle racial disparities in reproductive medicine and maternal health. In funding multidisciplinary research projects across the four main areas of basic and translational research, clinical research, epidemiology and prevention research, and social science research. Fittingly, the programme also welcomes submissions exploring racial disparities associated with COVID-19 infection, hospitalisation and health outcomes during pregnancy and birth. We work towards a near future that will see data capture affording its collators the remuneration, up-skilling and support they need and deserve, in order to preserve the resilience they have so powerfully developed. So here is to a Happy International Day of the Midwife, and a happy World Hygiene Day. I am proud to be an interlocutor, an advocate, and a tool of amplification for you all, and will continue to work in the direction of a better, respected and celebrated future for you, for mothers and for children.  

FROM April 19th, 2021

I am delighted to welcome and participate in the first day of the Institutionalising Community Health Conference , which focuses on Accelerating PHC at the Community Level. For many years, I successfully led Nigeria’s CSO PHC Revitalization Support Group which advocated successfully for Nigeria's redemption of the Abuja Declaration Pledge of 1% Consolidated Revenue Fund to Health. The 2018 Basic Healthcare Provision Fund BHCPF HUWE, Comprehensive Community Healthcare has remained a core target of my Wellbeing Foundation Africa's mission, vision and actions ever since. By addressing the wider factors that may delay or hinder the holistic delivery of Community Health Management and Quality, enables us to place a strategic lens on how optimal health outcomes, and increased equitable access to care can, and should remain a priority.  Globally, when we demonstrate an intentional, collective and results-based commitment to the facilitation of Universal Health Coverage and a quantifiable delivery of a Continuity of Care, we are able to actualise equal access to health care, move into promoting a truly universal and affordable healthcare system, and most importantly, place quality at the heart of community care - for any and all.  It is important to galvanise funding and action in order to strengthen primary care access and in order to keep essential public health services functioning.  How do we succeed in doing so? By ensuring that the primary conversations held ahead of any disbursement, allocation, policy creation or protocol implementation is being had with the most remote and vulnerable people in mind - and within view. This is how we collectively maintain our social and civic responsibility, as well as keeping the integrated health services of every community alive.  Multi-sectoral policy and action must reflect and empower the very people and communities it is formed to serve, and the health and wellbeing of said individuals is the effective and most precedential place to begin - and continue. For me, strengthening localised approaches to UHC, means we can successfully begin the transition into delivering community health coverage (CHC) - a journey where  the task and charge is to minimise discrimination, strengthen and revive strained approaches to cultural sensitivity, and straighten the pathway to putting the ‘U’ in universalism.  We must increase targeted and inclusive investments and make the road to care more generally accessible - starting with Maternal and neonatal health. When we recognise the importance of EmONC training, facilitation and care - including displaced persons and refugees - we make the case for equitable access even stronger. Factors such as malnutrition, language barriers, no fixed address and underlying health / obstetric conditions place these women and neonates within a higher risk category and makes them more prone to complications; preconception, antenatally, intrapartum and postnatally. What then is the purpose of Institutionalizing Community Health? A revival; a call to action that requires true, palpable and equitable action to take place.  

FROM April 9th, 2021

It is time to build a fairer, healthier world. It is time to build back better If the global COVID-19 pandemic has taught us anything, it is that our basic human rights and access to decent health and care is far from being a lived reality for millions of people around the world. Timely, optimal and affordable healthcare which is facilitated to an appropriate quality and standard, is often a dream for the 1.8 billion men, women and children who face appalling conditions inside hospitals and local health clinics. The problems they often face? A lack of Water, Sanitation and Hygiene (WASH) among others. Today, 50% of healthcare facilities in Least Developed Countries lack even basic water services - a resource and a solution in tandem, that if provided, would both cure and prevent a number of complications, illnesses and deaths. We cannot actualise health equity if we do not consider and prioritise the role and place of adequate WASH across any and all facilities. In 2019, my Wellbeing Foundation Africa committed to training 500 healthcare workers and educating 35,000 pregnant and nursing mothers across Nigeria on hand and personal hygiene practices by 2020. We also committed to advocating for improved WASH structures in healthcare facilities in 2019 and 2020 to enable healthcare workers in Nigeria to perform their duties effectively - a timely initiative which I firmly believe ingrained the practice’s importance in the hearts of Nigeria’s women and families just in time for the pandemic. We are proud to be part of the 100 global commitments to WASH in Healthcare Facilities made over the last 3 years, driving a rally cry to transform this  "neglected crisis" within global health into a global health movement with Global Water 2020 and Global Health Council. In the words of Dr. Maria Neira, Director of Public Health and Environment at the World Health Organization, "a healthcare facility without WASH is not a healthcare facility."  I join UN Secretary General Guterres, WHO Director-General Dr. Tedros, UNICEF Executive Director Fore, heads of state and First Ladies, Ministers of Health, Vatican officials, the Dalai Lama and so many more in a global call for funding, technical assistance, research, training, maintenance and advocacy.  WASH is an essential service and progress to get it into healthcare facilities will be among the most critical global health advances we can make in our journey to equal health for all. Crowning the 2021 World Health Care Worker Week by lending my solidarity and by commending, honouring and celebrating our global frontline, who championed the importance of WASH through aseptic techniques when facilitating care, by committing to WASH long before the global pandemic, thoroughly during the height of the waves, and hopefully so, going forward. Thank you. #WorldHealthDay # WASHinHCF #WASHWednesday  

FROM April 1st, 2021

I’m delighted to join WHO in welcoming its 2021-2030 Neglected Tropical Diseases Roadmap, and anticipate the emergence of the renewed Global Strategy for Water, Sanitation and Hygiene. Ending the neglect to attain the Sustainable Development Goals: a road map for neglected tropical diseases 2021−2030 was prepared through an extensive global consultation pursuant to decision EB146(9) of the Executive Board at its 146th session in February 2020 that culminated in the endorsement of the document by the Seventy-third World Health Assembly in November 2020. The road map sets global targets and milestones to prevent, control, eliminate or eradicate 20 diseases and disease groups as well as cross-cutting targets aligned with the Sustainable Development Goals. Three foundational pillars will support global efforts to achieve the targets: accelerate programmatic action (pillar 1), intensify cross-cutting approaches (pillar 2) and change operating models and culture to facilitate country ownership (pillar 3). The disease summaries annexed to the road map detail the current epidemiological status and burden of disease, core strategic interventions and progress towards the 2020 targets of the previous road map. The targets, sub-targets and milestones for 2030, and the critical actions required to achieve them, were used to generate the evidence in the road map document endorsed by the World Health Assembly. My Wellbeing Foundation Africa serves as an example of the powerful role that community facilitation of WASH plays in successfully inhibiting all 20 NTDs; from outright prevention and effective treatment, to reducing the prevalence of many more by between 33 to 70 percent (including intestinal worms which half a billion school children are at risk of.) Ensuring that access to WASH is made truly equitable remains an ongoing priority - the global strides taken to end all of the 20 NTDs mentioned within the roadmap will accelerate this much needed equity. As we continue to underpin WASH in every Covid-19 response worldwide, we further strengthen and reiterate its importance, and in so doing, place greater value on water as a resource greatly required by every girl, boy, woman, man and child.  We must embrace a multilateral approach across a plethora of sectors, and join WHO in reiterating the importance of increased and targeted investments and global awareness raising strategies that highlight the reach and impact of collective action now  

FROM March 24th, 2021

Every day, nearly 4000 people lose their lives around the world to Tuberculosis. That’s over 160 people an hour and at least 2 people every minute.  The clock is ticking and the priority remains to accelerate preventative action globally, to address health risks and social determinants of the disease nationally, and to further promote access to #UHC at the subnational and local levels to end TB.  According to the World Health Organisation's 2020 Global TB Report, in 2019, 440,000 people fell ill with TB in Nigeria and 155,000 avoidable death certificates were attributed to this deadly disease. As at 2019, TB treatment coverage stood at 27% - a far cry from the 2025 target of 90% operational target to end TB; although promising, the treatment success rate was 87%. People can and do recover - but, we must do more and do better to detect, prevent, treat and support our communities. My Wellbeing Foundation Africa team works daily to improve RMNCAH+N - alongside prevention, detection, treatment, and support which provides the pathway to achieving the vision of ending Tuberculosis by the year 2030. Last year, through collaborating with Nigeria's National Tuberculosis and Leprosy Control Program (NTBLCP), we visited health facilities and communities in the FCT and Nassarawa state, to health and care workers at the front of the frontline fight against the disease. During a lecture regarding the spread of TB in Nigeria led by our WBFA Abuja Mission Lead Dr Otun Adewale, Dr. Ogedengbe Babatunde, Provost Divine Jubilation College of Health Technology for Masaka, Nasarawa State shared, “it is sad to learn that Nigeria is being hit the worst in Africa and 5th in the world when it comes to TB. It’s even harder to hear that the largest impact is attributed to children, women of reproductive age and people living with HIV.”  [caption id="attachment_1516" align="alignnone" width="1024"] Dr. Ogedengbe Babatunde, Nassarawa State[/caption]   His conclusions further emphasise the need for targeted educational efforts, and empowerment of people - before they become patients. I commend every effort made by my own foundation’s frontline staff, and our global health heroes, and will continue to call for whole-system support for professionals and patients alike. We must continue to focus our progress in the direction of uplifting frontline morale, devising authentic and targeted approaches taken to maintaining their own health and wellbeing at the most localised level. We can do this by ensuring that equipment and PPE are made available and investments and donations are made in the direction of training and continued up-skilling.  A further and key component in addition to increased donorship is that the actualisation of Universal Health coverage and health security are closely interlinked.  Dr Tedros Adhanom Ghebreyesus, Director-General of the WHO, refers to Universal Health Coverage as a “political choice, and that it is the responsibility of every country and national government to pursue it.” In Nigeria and in many other countries, he is also right to point out that health security and universal health coverage are closely interlinked. Public campaigns and mobilisation must seek to educate all individuals and raise awareness, so that early detection and prevention are possible. While resources may be scarce, innovative and strategic management is key to overcome structural hurdles. These are the practical steps we can take as the clock turns. Together, and even in the mammoth shadow of the Covid-19 pandemic, we can achieve zero TB-related deaths and save lives, before the clock runs out.  Wishing you a targeted and more progressive #WorldTBDay.

FROM March 20th, 2021

I am both horrified and saddened by the atrocities and breaches of human rights reported as presently occurring in the Ethiopian province of Tigray. Following many years of the country’s collaborative attempts to recalibrate societal attitudes and behaviours, by promoting unity and tolerance for all persons, we are today, met with the devastating news and evidence of inexplicable acts of harm and violence towards women and girls. War is the destructive debasing of a united people - but to then fall victim to rape is a devastating low of sexual violence in conflict, in a war which unfairly divides and deprives humanity of dignity and autonomy. Cowardly and inhumane crimes such as these must be dealt with and stamped out, fast - and appropriately. I am urging for government and policymakers, people of power and community members to speak up for the application of United Nations Resolution 1325 on women, peace and security, and the prevention of sexual violence in conflict. Perpetrators should be identified and reprimanded swiftly and appropriately.  

FROM March 8th, 2021

Seed Global Health IWD 2021 Keynote Speech: Women's equity within the health and care workforce - honing in particularly on the importance of up-skilling, equal remuneration and putting the 'front' in frontline.

  [embed]https://youtu.be/Uy7G4qCVNjo[/embed]   I am delighted to join Vanessa, and 11 amazing change-agents, table-shakers and thought-leaders committed to reigniting the road to equity in global health for all. Your steps; our strides, are a timely jolt as we come together in choosing to challenge and improve the timeless journey for female healthcare workers worldwide. This year’s International Women's Day is a marvellous opportunity at a precarious time yet a hopeful one. During this annual, global moment dedicated to recognising and celebrating the social, cultural, economic and political achievements of women, this year, as we take stock of the events which preceded this very day, we are reminded of the unique challenges faced by women and girls around the world - and their continued commitment to undoing and overcoming them all. Last week, I joined the WHO PMNCH Partnership for Maternal Newborn and Child Health and United Nations Women's Fund in welcoming, and rendering commitments to the Gender Equal Health and Care Workforce Initiative of the Government of France, WHO, and Women In Global Health - to increase visibility, advocacy, dialogue, technical output, and commitment to action on improving gender equity in the health and care workforce alongside the UN Women Generation Equality Campaign to accelerate gender equality actions. To date, policies have attempted to fit women into inequitable systems that do not seek to serve their commitments, capacity or level of innate caring abilities. Because of COVID-19, 4x as many women dropped out of the labor force in 2020 as men worldwide. The onus is on each member of society to identify and recalibrate existing systems, policies and work environments, in order to create a culture of work for women that promotes and provides the ability for them to thrive, and closes gender gaps in leadership and pay.  Recognised as the main providers of health, women deliver care to around 5 billion people globally, and creating safe and enabling environments where we can work to our full potential is critical to achieving health for all and improving the well-being of our own personal communities. Today, Women make up 70% of the global healthcare workforce, yet occupy less than 25% of influential leadership positions. We contribute $3 trillion to health care globally, however nearly half of the care we commit to facilitating is unpaid. This must change, and a bottom up approach is a strong, authentic and powerful place to begin this reposition. Thought-leaders and policymakers will continue to gather throughout March to identify, celebrate and increase the visibility of women’s achievements; they help forge equality through strategic collaborations based on shared purpose, trust and the appreciation of impacting positive change for women. We are boldly choosing to challenge gender bias and discrimination in order to accelerate gender parity in the health and care workforce, meticulously marching on towards a decade of delivery for the sustainable development goals, and a gender equal world by 2030.   As a worthy precursor to this very day, and in this Year of the of the Health and Care Worker, I have endorsed the clarion call for a Gender Equal Health and Care Workforce, to further recognise and reinforce the capacities and impact of nurses, midwives and community health and care workers at the forefront of providing essential services around the world. The report of the UN High Level Commission on Health Employment and Economic Growth concluded that investments in education and job creation in the health and social sectors result in a triple return of improved health outcomes, global health security, and inclusive economic growth. When we look at the progress made through upskilling Nigeria’s healthcare professionals in previous years, the importance of accredited and assessed evidence-based practice and care facilitation has been a central and vital component. It has not only strengthened the promise of career progression, but affords and assures the safety and provision of an uncompromised work environment for the health and care giver, and for their family when it comes time for ‘clocking off.’  Taking a deep-dive into case studies such as the successful eradication of the wild polio virus in Nigeria, we have seen that females on the frontline have been instrumental in building trust within communities, and thus, successfully facilitating uptake of vaccinations and immunisations. I urge the wider world to glean from such successes, while acknowledging this and many other components as evidence for the increase. My WBFA’s Mamacare360 Antenatal and Postnatal Education program remains committed to administering care and informing evidence-based counsel to women and families, and more recently, the height of the pandemic served as a ready and powerful example of the purpose equity has in promoting gender leadership - in care, in counsel and in community. Our success in delivering a quality continuum of maternity, newborn and child health care serves as proof and support for increased investments in the direction of upskilling and responsibilities.  With the core goal of empowering health-workers to propel safer births and healthy futures for all, since 2016, my Wellbeing Foundation Africa has partnered the Liverpool School of Tropical Medicine, supported by Johnson and Johnson Global Health to improve the availability and quality of emergency obstetric and newborn care in Nigeria, deploying pre and post-service anatomically correct simulation models training, and the results are clear: an immediate and sustained 22% drop in mortality and morbidity, improved task shifting between doctors, midwives and nurses, and swift appropriate responses to obstetric and newborn emergencies, cascading into better decision making and leadership and a truly multi-disciplinary approach to care. For our targeted pioneer state, Kwara, in North Central Nigeria, we have achieved the lowest maternal newborn and child mortality, and highest commensurate survival, repeatedly, for the last 4 years, in Nigeria.    This is what the global frontline requires, and desires to have access to. The determined and skilled professional community health-worker even in the most rural parts of sub-saharan Africa for example, dreams of inner-city impact beyond leveraging the locality they begin with. This will only be made possible by way of up-skilling, adequate and equal remuneration, and qualifying him or her as a vibrant and accredited professional healthcare practitioner. Increasing investments from the start of a CHW’s journey, and dream in the direction of impact, is therefore vital. Midwives, nurses and the community health workers who aspire to follow in their footsteps are more commonly women, and have proven to be effective in facilitating better maternal and child health outcomes, essential newborn care, effective SRH education and the promotion of breastfeeding and immunisation, and we must ensure that our healthcare policies reflect that of equal remuneration and equal access to facilities - truly personifying the front in frontline. In the 2020 Year of the Nurse and Midwife, I was pleased to crown the conclusion of my second term and 6 years of service as the Inaugural Global Goodwill Ambassador to the International Confederation of Midwives in leading my Wellbeing Foundation Africa to join Member States and Non-State Actors at the 73rd WHO World Health Assembly, in unison, speaking to the critical role of health and care workers in ensuring our health and prosperity. We emphasized the urgency and made it imperative to address persistent health worker challenges.  Ahead of this year’s 74th World Health Assembly, recognising the need to advocate for a gender equal health and care workforce, the Wellbeing Foundation Africa which had launched its own Women Girls and Gender Development Targets in November 2020 wholeheartedly endorses and supports actions in the health and care sectors in the 4 identified areas:
  • Increasing the number of women health workers in leadership roles
  • Recognising the value of unpaid health care work and the importance of equal pay in the health and social sectors
  • Protecting women health workers from harassment and violence in the workplace
  • Ensuring safe and decent working conditions for all health workers
From the community healthcare worker aspiring to facilitate life’s first cry, to the autonomous and multi-skilled practitioner working to ensure the promise of optimal care, the priority must remain; to provide the appropriate health facilities whole-system support infrastructure to welcome, protect and preserve life from cradle to age. In choosing to challenge and strengthen the primary health frontline where lives are won, the Wellbeing Foundation Africa has developed, and invested in improving primary health centres, evolving a uniquely unprecedented comprehensive community care model to maternity referral standard, as our Wellsprings Universal Health Coverage Centres to be expanded across Nigeria, throughout this Decade of Action. The Wellbeing Foundation Africa is committed to tackling health, gender and global development together, as we prioritise equity, facilitate decent work conditions and increase investments in the direction of upskilling in a bid to position the doctor, the midwife, the nurse, and all female healthcare workers, towards a gender equal health workforce, truly leading at the front of the frontline. Making our commitments to the ethical principles and practices of the WHO Global Code of Practice on the International Recruitment of Health Personnel (Code), we continue to urge prioritization of support and safeguards for the countries with the greatest vulnerability, including greater investment, and endorsed the call to action for WHO and development partners to strengthen its financing, implementation and monitoring and moving purposefully beyond applauding the contributions of the frontline health workforce, to deliberate and intentional investments in health, health systems and in health and care workers. We must now, at our global, national and subnational frontlines, ensure that this key consensus necessarily unites, includes and integrates a gender equal approach to capitalise female leadership in the global health workforce. -End of keynote-

FROM March 7th, 2021

A worthy precursor to International Women's Day 2021 in the Year of the Health and Care Worker: Amplifying the clarion call for a Gender Equal Health and Care Workforce.

  On Thursday, 25 February, I joined the WHO PMNCH Partnership for Maternal Newborn and Child Health and United Nations Women's Fund in welcoming, and rendering commitments to the Gender Equal Health and Care Workforce Initiative of the Government of France, WHO, and Women In Global Health - to increase visibility, advocacy, dialogue, technical output, and commitment to action on improving gender equity in the health and care workforce alongside the UN Women Generation Equality Campaign to accelerate gender equality actions. As a worthy precursor to International Women's Day 2021, in this Year of the of the Health and Care Worker, I have endorsed the clarion call for a Gender Equal Health and Care Workforce, to further recognise and reinforce the capacities and impact of nurses, midwives and community health and care workers at the frontline of providing essential services around the world. As leaders and policymakers gather throughout our Women’s Month of March to identify, celebrate and increase the visibility of women’s achievements, they help forge equality through strategic collaborations based on shared purpose, trust and the appreciation of impacting positive change for women. We are boldly choosing to challenge gender bias and discrimination in order to accelerate gender parity in the health and care workforce throughout the Year of the Health and Care Worker, marching on towards a decade of delivery for the sustainable development goals, and a gender equal world by 2030.   Long before the first COVID-19 case was reported, a spotlight was shone on the heroes and heroines who mustered and mastered managing many of the ‘medical waves’ that preceded it.  It is indeed far from new news, that a host of countries have, and do continue to face inadequacies and challenges in their workforce, particularly regarding staffing levels and the maintenance of their morale and momentum. In 2016 it was estimated that an additional 18 million healthcare workers would be required in order to actualise Universal Health Coverage. Now COVID-19 is creating an additional burden in the form of health worker deaths, infection, exhaustion, mental trauma, long-COVID, and attrition. As we progress through the International Year of the Health and Care Worker, we have an unprecedented opportunity to powerfully recognise, re-position, and reverberate our policies as a clarion call to a much needed global revival of their empowerment through autonomy within the health and care worker professions, and by way of assuring a patient’s continuum of (health) care. When we look at the progress made through upskilling Nigeria’s healthcare professionals in previous years, the importance of accredited and assessed evidence-based practice and care facilitation has been a central and vital component. It has not only strengthened the promise of career progression, but affords and assures the safety and provision of an uncompromised work environment for the health and care giver, and for their family when it comes time for ‘clocking off.’  

Setting the precedent for success in Nigeria - the eradication of wild polio virus

  Taking a deep-dive into case studies such as the successful eradication of the wild polio virus in Nigeria, we have seen that females on the frontline have been instrumental in building trust within communities, and thus, successfully facilitating uptake of vaccinations and immunisations.  The national polio eradication programme led through the Emergency Operations Centre (EOC) and in partnership with the WHO and Global Polio Eradication Initiative (GPEI), successfully leveraged a gender strategy that addressed the challenges of gender inequalities in immunisation and vaccination. The approach ensured that all house-to-house vaccination team members for the polio campaign were females in order to guarantee access to children both inside and outside of the house.  The multidisciplinary team sent out to women and children in hard-to-reach settlement areas also comprised at least one nurse or midwife and a host of community health extension workers. The female polio workers in particular, provided vital information about immunisation and other health related interventions available at the health facilities during their interactions with caregivers in the household. Pregnant women received antenatal care, malaria preventive therapy, iron folate, tetanus toxoid vaccine and treatment of illnesses (e.g. malaria and respiratory infections) or referral for care. Children aged 0–59 months received a full complement of routine immunizations (including oral polio vaccine), vitamin A supplements, deworming, diagnosis and referral for malnutrition, treatment of diarrhoea, pneumonia and malaria and additional referrals as required. In addition, all women attending outreach sessions were provided with health education on key household practices; hand washing, personal hygiene and infant feeding including exclusive breastfeeding. Ultimately the responsibility was not just to eradicate the polio virus, but to ensure a healthier life after the virus itself.  Even in the weakest of healthcare infrastructures, female health workers demonstrated an ability to deliver quality healthcare for all.  My WBFA has remained committed to administering care and informed accurate counsel to women and families even at the height of the pandemic, and their success in delivering a quality continuum of maternity, newborn and child health care serves as proof and support for increased investments in the direction of upskilling and responsibilities.  This is what the frontline requires, and desires to have access to. The determined community health-worker even in the most rural parts of sub-saharan Africa dreams of inner-city impact beyond leveraging locality. This will only be made possible by way of up-skilling, adequate remuneration and qualifying him or her as a vibrant and accredited professional healthcare practitioner. Increasing investments from the start of a CHW’s journey, and dream in the direction of impact, is therefore vital.

Strengthening routine maternity and child health services in a pandemic: could nurses, midwives and community healthcare workers capitalise the Covid-19 response?

  Midwives, nurses and the community health workers who aspire to follow in their footsteps are majorly women, and have proven to be effective in facilitating better maternal and child health outcomes, essential newborn care, SRH education and the promotion of breastfeeding and immunisation, and we must ensure that our healthcare policies reflect that of equal remuneration and equal access to facilities - truly personifying the front in frontline. Growing studies such as the ICM, UNFPA, WHO 'Impact of Midwives' published in Lancet Global Health estimate that, relative to current coverage, universal coverage of midwife-delivered interventions would avert 67% of maternal deaths, 64% of neonatal deaths, and 65% of stillbirths, allowing 4·3 million lives to be saved annually by 2035. Lives saved can only be accomplished through realising the unabridged potential of midwives, through augmented skills and competencies, conducive teams and enabling work environments by way of increased investments. If increased coverage and efficacy of midwife-delivered interventions can be achieved, national and subnational health systems will provide more effective coverage of essential sexual, reproductive, maternal, newborn, and adolescent health interventions. In the 2020 Year of the Nurse and Midwife, I was pleased to crown the conclusion of my second term and 6 years of service as the Inaugural Global Goodwill Ambassador to the International Confederation of Midwives in leading my Wellbeing Foundation Africa to join Member States and Non-State Actors at the 73rd WHO World Health Assembly, in unison, speaking to the critical role of health and care workers in ensuring our health and prosperity. We emphasized the urgency and imperative to address persistent health worker challenges.  Ahead of the 74th World Health Assembly, recognising the need to advocate for a gender equal health and care workforce, the Wellbeing Foundation Africa which had launched its own Women Girls and Gender Development Targets in November 2020 wholeheartedly endorses and supports actions in the health and care sectors in the 4 identified areas: Increasing the number of women health workers in leadership roles, recognising the value of unpaid health care work and the importance of equal pay in the health and social sectors, protecting women health workers from harassment and violence in the workplace, ensuring safe and decent working conditions for all health workers. From the community healthcare worker aspiring to facilitate life’s first cry, to the autonomous and multi-skilled practitioner working to ensure the promise of optimal care, the priority must remain; to welcome, protect and preserve life from cradle to age.  For my native Nigeria, the last six years in particular have demonstrated that fervency and commitment towards tackling outbreaks of deadly disease lies in repeated and robust methods of prevention, namely vaccination and medical equity, ensuring dissemination of information is evidence-based, culturally-sensitive and digestible, all while building a societal trust that averts a culture of hesitancy to any treatment of any kind.  The Wellbeing Foundation Africa is committed to tackling health, gender and global development together, as we prioritise equity, facilitate decent work conditions and increase investments in the direction of upskilling in a bid to position the midwife, the nurse, and all female healthcare workers, towards a gender equal health workforce, truly leading at the front of the frontline. Making our commitments to the ethical principles and practices of the WHO Global Code of Practice on the International Recruitment of Health Personnel (Code), we continue to urge prioritization of support and safeguards for the countries with the greatest vulnerability, including greater investment, and endorsed the call to action for WHO and development partners to strengthen its financing, implementation and monitoring and moving purposefully beyond applauding the contributions of the frontline health workforce, to deliberate and intentional investments in health, health systems and in health and care workers. To quote Her Royal Highness Princess Muna of Jordan, at the 73rd World Health Assembly, “applause without action is no longer acceptable. Recognition without rights and proper remuneration is not sufficient. A resolution without implementation is not governance. We must invest in health workers.”  I endorse Her Royal Highness’ sentiments to further urge all Member States, International Financing Institutions, Global Health Initiatives and partners to invest in health workforce readiness, education and learning, to manage the pandemic, maintain health services and roll out the COVID-19 Vaccine, the WHO has given clear direction on consensus and the necessary actions on the health and care workforce. We must now, at our global, national and subnational frontlines, ensure that this key consensus necessarily unites, includes and integrates a gender equal approach to capitalise female leadership in the global health workforce.

FROM January 30th, 2021

This World NTD Day, the Neglected Tropical Disease (NTD) community is further shining a light on the critical role that access to clean water and sanitation plays in the prevention of these illnesses. The just-launched World Health Organization (WHO) NTD road map is a clear indication that tides and times are changing, with a much needed focus being placed on the need for increased incorporation of water, sanitation and hygiene (WASH).  According to the CDC, 100 percent of low-income countries are simultaneously affected by at least five of the 20 parasitic, bacterial, viral and protozoan infections grouped together as NTDs, and 149 countries and territories are affected by at least one NTD. 1.7 billion people worldwide live with these diseases that deform bodies, blind and kill, disrupt children’s education, limit lifetime productivity; and ultimately traps families and communities in cycles of poverty that contribute to crippling economies.  My Wellbeing Foundation Africa serves as an example of the powerful role that the facilitation of WASH plays in  successfully inhibiting all 20 NTDs; from outright prevention and effective treatment, to reducing prevalence of many more by between 33 to 70 percent (including intestinal worms which half a billion school children are at risk of.) Except... three billion people do not have access to water in their home. 900 million children go to schools without accessible handwashing facilities, and in the battlegrounds of disease itself, nearly 2 billion patients and healthcare staff must rely on healthcare facilities without water where care is provided. Sadly, access to WASH is that neglected. I believe and continue to demonstrate that the solution for combatting NTD’s starts and ends with WASH – a message that the onset of the global pandemic successfully communicated to members of the NTD community. The global health focus must continue to shift from solely reflecting treatment as the primary solution, and embrace the power of prevention through WASH. The Covid-19 pandemic has caused policymakers, global health advocates and donors to step away from a culture that previously undermined the relationship between WASH and disease prevalence. For a fifth year in a row, last year one billion people were treated for NTDs. While this is extraordinary outreach, it begs us to question how much of that suffering could have been prevented all together if children weren’t drinking intestinal worm-laden water and women weren’t irreversibly blinded at four times the rate of men by flies thriving in open waste? Despite excellent work being done to bring needed attention to these 20 diseases that attack the most vulnerable, and the efforts to get medications to them, the economic toll remains high and the human suffering remains devastating.  This is no small problem and my country, Nigeria, is a case in point.  According to WaterAid, 95 percent of healthcare centers in Nigeria are without basic WASH provisions, as well as 79 percent of all households. It is both alarming, and no surprise, that in a country where the majority of its citizens lack WASH and ranks first among nations in open defecation, half of its population—an estimated 100 million people—are at risk for at least one NTD. Nigeria carries 25 percent of Africa’s entire NTD burden. In 2013, the Federal Ministry of Health sought to reduce NTD morbidity and mortality, including by scaling-up WASH and other interventions—a step in the right direction. Guinea worm has been eliminated in Nigeria with a dramatic decline in three other NTDs (lymphatic filariasis, onchocerciasis, and trachoma which causes irreversible blindness). But Nigerians are far from NTD-free and even farther from having the water and sanitation they deserve. One of the goals of my organization, The Wellbeing Foundation Africa (WBFA), is to improve health outcomes for women, children, and infants. We are committed to improving and increasing access to WASH in healthcare facilities, schools and communities across Nigeria, in a bid  to reduce and eventually eradicate the prevalence of NTDs. WBFA’s team of midwives, in partnership with Unilever Lifebuoy Nigeria and Sightsavers, have reached more than two million children at-risk of NTDs, all while improving the education and hygiene practices. These school-based efforts reinforced in children, their families and communities the importance of prioritising WASH interventions, including handwashing with soap.  The new WHO NTD road map is a much welcomed northern star. For the first time, there is a global target for WASH that countries must meet over the next 10 years – a solidified set of directions that will mark long-term change at each juncture. A companion strategy on integrating WASH will follow later this spring and making way for new collaboration calls for investments, programming and policies to assure universal and sustainable WASH coverage in NTD endemic areas, otherwise, we risk losing the gains made in reducing NTDs over this past decade and into the future.  COVID-19 has ushered in greater understanding of the integral role WASH plays in public health. It is fair to say, that unacceptable WASH conditions not only fan the flames of COVID-19 where people cannot adequately wash their hands, they contribute to many less infamous but pervasive diseases that cause great harm, like, NTDs. At a time when the world is focused on global health, the NTD community is offering important leadership that I hope will encourage many other global health efforts to stop neglecting what is the singular foundation upon which to build better health. About the Author: Her Excellency Mrs. Toyin Saraki is Founder/President of the Wellbeing Foundation Africa (WBFA). She is a former regional First Lady and Nigerian philanthropist who has spent two decades as a global advocate on behalf of women. She is a former two-term Global Goodwill Ambassador for the International Confederation of Midwives and a Special Advisor to the Independent Advisory Group of the WHO’s Regional Office for Africa. @ToyinSaraki

FROM January 29th, 2021

Reflecting on the challenge of reinforcing and replenishing community-centred care during covid-19.

Download my 2020 annual review here

In 2020, the power and determination of people around the globe were faced by an unprecedented set of circumstances - the coronavirus pandemic. Reflecting on the challenges that arose, and remembering the many lives affected and tragically lost during this turbulent time, I can conclude that the moving parts of my programmatic and advocacy strategy had intuitively developed the key resilience, innovation and agility required to face the many variations of each day, head on. To arrive at a place of strength following a journey through unpredictability, shows that we’ve come a long way. From my own personal experiences that structured my philanthropy, to applying learning and knowledge everyday I continued to take every opportunity to advocate for better maternity and health conditions of women, newborns, children and adolescents, and my Wellbeing Foundation Africa reached over 96,000 families, and 62,800 frontline health workers - even during the pandemic. Armed with decades of frontline experience and informed by the everyday stories of the beneficiaries of the Wellbeing Foundation Africa, I am guided by the core themes of WASH, improving the social determinants of health and wellbeing, poverty alleviation, economic empowerment, promoting global public health advances, the rise of women and girls, and harnessing the promise of technology which underpin my broader goal and that of the Wellbeing Foundation Africa, in working to reduce maternal and newborn deaths (SDG 3.1 and 3.2). I continue to advocate for greater innovation in tackling pressing contemporary topics such as beating non-communicable diseases, improving access to STEM education, maintaining the momentum behind the women’s equality movement, and the call for radical new ways of rebuilding sustainable economies and cleaner environments. As we navigate the coronavirus pandemic, we continue to prioritise our targets to end hunger and malnutrition through our Stronger Together collaborations to improve the SDGs. I reflect on 2020 by expressing my appreciation for the Trustees, Global Advisory Council, Vice President and entire Wellbeing Foundation Africa management and frontline teams in Nigeria and Ghana. Our consistent purpose in implementing our mission to end preventable deaths of mothers and children, improving nutritional outcomes, increasing access to WASH, supporting families through the reproductive health and education journeys, promoting gender equity for all, is actualised - daily. The 2021 Year Of Health And Care Workers finds us in our 17th year of dedicated philanthropic focus, extensive frontline programmatic actions and significant global, national and sub-national partnerships. I am pleased to share the 2020 Global Office & Philanthropy Annual Review.

Download the Report here.

FROM December 31st, 2020

We acknowledge and appreciate the support of all respected and esteemed friends and associates from all walks of life, including many others that we may have forgotten to mention.  Perhaps you sent a lovely card, or sat quietly in a chair, perhaps you sent beautiful flowers. If so, we saw them there. Perhaps you sent or spoke kind words and prayers, as any friend could say; perhaps you were not there at all, just thought of us that day. Whatever you did to console the heart, we thank you so much, whatever the part. Your kindness provided a soothing balm to the tragedy that Prince Adedapo’s sudden departure represents to us. Adedapo was our warrior Prince, our symbol of courage, bravery, valour and peace, who has gone to meet our ancestors. It is within our sober knowledge and wisdom that in every sunshine, a little rain must fall. We thank you for standing by us in our time of sorrow and we pray that Almighty God will continue to bless you all. Respectfully, and with grateful appreciation,   Adeyinka Adekunle Ojora and Toyin Ojora Saraki On behalf of the Ojora Royal Family of Lagos.  

FROM December 12th, 2020

The Ojora Family of Lagos sadly regrets to inform of the death of our dearly beloved son, brother, uncle and father, Omo-Oba Adedapo Adelanke Abdulfatah Ojora on Friday 11th December, at his Ikoyi, Lagos residence. We are grateful to the Lagos State Police Command for immediately commencing an investigation into the circumstances of his death - the outcome of which we await. As we mourn our irreparable and devastating loss, we appreciate the condolence messages and prayers that we have received, and seek your understanding that the family be allowed to grieve in private. Funeral arrangements will be announced in due course. We ask that you continue to pray for the repose of Adedapo's soul. Amen.  

FROM December 10th, 2020

It’s time to put the ‘move’ in movement; assessing the Role of Nigeria’s Multi-Disciplinary Health Response in Identifying, Establishing & Delivering Interventions in Cases of Violence Against Women and Girls (VAWG) On Thursday December 10th the Wellbeing Foundation Africa (WBFA) held its innovative #EndViolence Webinar. The well attended and highly discursive event was the culmination of the United Nations (UN) 16 days of activism against Gender Based Violence (GBV) which took place from November 25th to December 10th. The Wellbeing Foundation Africa’s commitment to ending gender-based violence and harmful practices as per the SDG’s three zeroes, extends beyond childbearing women at health facilities, and daily transcends into teaching our Adolescent Skills and Drills PSHE curriculum in schools across Nigeria. Our commitment here is to teaching adolescents what is deemed a healthy relationship and how to spot and respond to abuse including child marriages in a safe and trusted authentic space. Our health workers also seek to provide adolescents with personal social and health education on sexual and reproductive health and rights. The webinar brought together healthcare practitioners, midwives, policymakers, WBFA staff and those in the field of broadcast media/journalism with the objective of introducing them to WBFA’s newly developed protocol for recognising, referring and aiding victims of violence against women and girls whilst also identifying areas of co-operation to combat the growing cases of GBV in Nigeria. Speakers on the day parted with a multitude of knowledge, expertise and experiences which included the keynote address by the Founder-President of the Wellbeing Foundation HE Toyin Saraki, Dr Otun Adewale Olalekun, Abuja state team lead, WBFA, Dr Muna Abudullah, Health System Specialist at the United Nations Population Fund (UNFPA), Fati Abubakar a renowned photojournalist from Maiduguri, Borno State and Aisha Salaudeen, a multimedia journalist with CNN International. Throughout all our work, the Wellbeing Foundation Africa promotes and achieves the WHO’s recommendations on how countries can improve quality of care in their health facilities and prevent maternal and newborn deaths, based on its standards for improving quality of maternal and newborn care in health facilities, and even before a woman with child arrives  - as our accountability policy and targets - and we deliver this through our investment in community midwifery, localising care: 1)    Pregnant women should receive the right care, at the right times 2)    Newborns should receive essential care immediately after birth 3)    Small and sick babies should be well cared for in a facility 4)    All women and newborns must receive care that prevents hospital-acquired infections 5)    Health facilities must have an appropriate physical environment 6)    Communication with women and their families must be effective and respond to their needs 7) Women and newborns who need referrals can obtain them without delay 8) No woman should be subjected to harmful practices during labour, childbirth, and the early postnatal period 9) Health facilities need well-trained and motivated staff consistently available to provide care- 10) Every woman and newborn should have a complete, accurate, and standardized medical record. Addressing the silent pandemic of violence against women and girls (VAWG) is one of the cardinal focal points of WBFA’s engagement and policy strategy. According to UN Women, one in three women worldwide experience physical or sexual violence mostly by an intimate partner. Further studies estimate that in Africa, between 23 to 49% of pregnant women experience physical, sexual and emotional violence from an intimate partner during their pregnancy. There has been an increase in reports of gender based violence cases in all six geopolitical zones in Nigeria since the pandemic began but a lack of systematic data collection and a political/cultural system that favours the accused rather than the victim has meant that indices of violence against women continue to grow. This gave added importance to WBFA’s #EndViolence Webinar. The theme of the webinar was ‘Assessing the role of the multidisciplinary team in recognising, reporting and ultimately, reprimanding perpetrators in cases of VAWG’. The speakers actively discussed and detailed their roles as stakeholders in providing intervention plans for survivors and victims. H.E Toyin Saraki in her keynote speech detailed the intervention programmes of the Wellbeing Foundation Africa via their Wellbeing Midwives who have been trained to spot the early warning signs of a GBV victim, whilst the foundations Mamacare classes have remained a point of communication, community and safety for women throughout their pregnancy. Dr Abudullah described the tireless work of the UNFPA’s advocacy efforts in Africa in the areas of data gathering and analysis, increased training of healthcare workers to tackle the rising cases of GBV and by building a referral pathway system for the safe reporting of GBV victims. Photojournalist Fati Abubakar gave a candid insight into her work which has seen her go into the epicentre of the Boko Haram scourge & detail through a visual medium the tragedy taking place in north east Nigeria. She emphasised the importance of visualisation which gives strength to the story of the victim. Journalist Aisha Salaudeen, helped participants to understand the variety of ways to help illuminate the story of GBV cases, emphasising that news agencies must ensure not only the safety of the victim when describing their travails but also to adhere to a code of conduct to protect the dignity of survivors of GBV whilst also telling their story with empathy.  Dr Otun Olalekun provided a thorough case study of the ongoing advocacy projects and Initiatives the WBFA are currently conducting in the fight against GBV. This includes the creation of the community based adolescent program which helps teach young girls about GBV and how they can protect themselves and the continuation of the far reaching MamaCare program which has educated and engaged midwives and health workers in over 40 different facilities throughout Nigeria in the areas of S/GBV. The webinar provided a discursive platform for a plethora of professionals, advocates, health workers and policy makers to engage in an issue of great importance. It was resolved that collective efforts will be undertaken to engage key stakeholders in tackling S/GBV whilst focusing on enhancing frontline efforts, aiding security and shadowing facilitation and strengthening abuse referral processes. When I launched the Wellbeing Foundation Africa Global Foundation For Elimination of Domestic Violence by way of the Peace One Day collaboration back in 2012, I was on a trajectory towards what is today, the actualisation of my commitment to the #ICPD25 three zeros; zero unmet need for contraception; zero preventable maternal deaths; and zero gender-based violence and harmful practices, such as child marriage and female genital mutilation. Since then, my commitment to #endingviolence has remained a daily priority, and is personified through my Wellbeing Foundation Africa’s community midwives. The continuum of care offered by way of the  #Mamacare360 maternity programs, and every educator and practitioner’s efforts to remain working in tandem with the next generation of young men and women and their families through PSHE to tackle and contribute to the lessening of these dire figures remains both critical and crucial. As we unite to fund, respond, prevent and collect the key evidence and expertise to end this ongoing silent pandemic, I remain resolute in advocacy and actions towards recognising and championing human rights, safety, protection and justice to #endVAWG.    

FROM November 25th, 2020

The most powerful way for an advocate to authenticate her message, is to remain at the heart of the demographic requiring its voice to be heard, but equally so, to join forces with other committed voices.  My mission to confirm collective needs, develop solutions and provide for society's most vulnerable citizens means galvanising action and joining forces voices - during these #16days of activism and beyond.  Women and girls must be made safe, and we must #EndViolence, now.  Comfort Lamptey H.E. Jesper Kamp Siddharth Chatterjee Segun Awosanya Kingsley Moghalu and our own dear Wellbeing Foundation Africa Vice President Dr Alero Roberts  Thank you.  We are for others, who we are for ourselves.  #16days #WBFA16days [embed]https://youtu.be/O1bb09DeATw[/embed]

FROM October 21st, 2020

I am heartbroken, along with millions of Nigerian mothers, grandmothers, and women, to have borne witness to the killing of a still uncounted number of our nations young citizens, protesting peacefully, holding the flag of our nation, behind a barrier, at the Lekki Tollgate, on the October 20th, 2020.

Our nations young citizens were shot in cold blood as many of them sat on the ground singing our national anthem. They were shot by their own army, by soldiers whose job it is to protect them. And they were shot in the complete absence of members of Nigerias Police Force, whose job it likewise is to protect the lives and property of civilians, and who have sadly proven themselves to be under-trained, under-equipped and thus over-strained in times of crisis, incapable and unwilling to exercise the standard stewardship of crowd control.

It is no secret that the peaceful protests concern the glaring impunity and militarization of the Nigeria Police Forces Special Anti-Robbery Squads brutality towards young Nigerians which had reached the fever pitch of a public safety emergency, culminating in widespread reports of intimidation, harassment and extrajudicial killings – and that young people had organically risen, together, yet leaderless, to peacefully oppose this constant threat to their normal lives. In the last 24 hours, these protests were visibly disrupted in several cities by armed thugs. While the latter appeared to have the backing of the organs of state, in some instances they even killed innocent policemen. Last night, the Nigerian Army came out of its expansive barracks to controla group of protesters on the Lekki Bridge Toll Gate, linking two of Lagoss most exclusive residential communities. The young people had gathered peacefully behind a barrier as can be seen from all manner of media footage. The army fired live rounds not into the air but into the crowd, at close range, killing several and injuring an indeterminate number – in a flagrant contravention of the protocols of the International Covenant on Civil and Political Rights and the Rome Statute of the International Criminal Court. Moreover, in so doing the commanding officer ignored the human rights of freedom of speech and assembly, and the right to protest peacefully, despite Nigeria being a signatory to the ICCPR.

My ears have rung with the mournful blare of howling sirens ever since, as ambulances contributed by private hospitals made their way, with difficulty through the curfews and against the odds, to the scene of bloodshed and death, to try to provide care, for the injured, and the murdered dying.

Behind every statistic of inhumanity and injustice is a story, and behind each human being and young citizen is a family. The Nigerian flag, standing for peace, progress and unity, has been indelibly stained with the blood of our young citizens, who themselves were protesting against the SARSs notorious record of thousands of incidents of rape, torture, un-anaesthetised testicular castrations, and extra-judicial killings, not to mention wanton acts of theft – the very crime it was established to curb. As a mother and grandmother, and I know I am not alone, I fully understand the determination of the youth movement advocating peacefully to #EndSARS and #ReformPoliceNG in Nigeria. At the same time, as a patriot, I am deeply concerned by the disruptions to the nation's safety, peace and productivity.

To build a nation, youth empowerment and youth development should be supported as a process where young people are encouraged to take charge of their lives. They should be supported as they address their situation, transform their consciousness through their own beliefs, values, and attitudes, and take action in order to improve their lives. Youth empowerment is a gateway to much needed inter-generational equity, civic engagement and democracy building.

Many have called for our nations youth to sheathe their swords, appoint leaders and representatives to embark on dialogue with belatedly yet urgently assembled government commissions – but we must recognize this incontrovertible fact: the youth never had any swords.

All they had were their voices, hopes, aspirations and patriotism. If their words were swords, then we know how frightening words must be for the current administration.  How can an invitation to sit down at a table for proposed dialogue be so frightening as to be simultaneously accompanied by fatal aggression and bloodshed? Who called our army out to kill, maim and injure our nations youth – all of whom eagerly and enthusiastically give a year of their efforts and energies to our mandatory National Youth Service Corps.

It is a travesty, and a crime, that young Nigerians should be shot in cold blood simply because they empowered themselves to develop and declare five wishes to live, work and prosper with respect and rights, as occurred on 20th October, 2020. Silence is not an acceptable answer amidst the public calls for dialogue, and Nigeria must hold itself to account.

I urge Nigerian officials and the Nigerian military, to immediately cease the violent and in part fatal crackdown on peaceful protesters in Nigeria. I urge the Nigerian Police to redouble its discipline to safely secure lives and property. My heart is broken along with all those who have lost a loved one in the violence. I ask the world and the diplomatic community to stand with Nigerians who are peacefully demonstrating for police reform and an end to injustice and corruption in our democracy.

I thank the churches and religious leaders, who threw open their parish doors to offer our nations young citizens refuge and have sought to encourage the government to engage in a good-faith dialogue with civil society. It is time to address these long-standing grievances and work together for a just, inclusive, peaceful and united Nigeria. I thank the hospitals that have worked tirelessly and free of charge to do what they could to treat the gunshot wounds many young people had. It was an act of profound solidarity at a time when our nations officials abandoned our young. For the blood of Nigerias young citizens that has been spilled, for daring to raise their voices to peacefully demand a better future of inter-generational equity and accountability for all, we must do our utmost to ensure that their blood was not shed in vain. Our nation just celebrated 60 years of independence, autonomy, agency and governance. We remain in measured hope as we pray that our young citizens continue to surpass us in their achievements, and we will not forget.

FROM October 15th, 2020

We’re all scrambling to wash our hands, but handwashing isn’t reaching women who are the backbone of societies.

How poignant it is that Global Handwashing Day, during the greatest pandemic in modern history, falls on the same day as International Day of Rural Women? Rural women are at once the backbone of our society and the most stifled by a lack of access to water, sanitation and hygiene resources. Globally, throughout shutdowns and lockdowns, rural women are continuing to do the work to provide the sustenance that each and every one of us needs to be able to survive the day. Rural women are predominant in the field of agriculture (globally, one in three employed women works in agriculture, which rings true to Nigeria as well). Rural women protect our food security and support our nutrition, manage our land and subsequently our natural resources. They are on the frontline when the elements that support our homesteads are threatened, as they are most responsible for unpaid domestic care work.  At the same time, the most prominent advice that we have to prevent the spread of the pandemic is to wash our hands. So while some companies alter their supply chains to create hand sanitizer and new handwashing stations are installed in developed countries’ public spaces, the fact remains that over 2 billion people globally lack basic access to handwashing facilities, primarily in developing countries like Nigeria. The lack of access to WASH facilities for handwashing is most prevalent in rural communities: in Nigeria, 70% of households in rural communities do not have access to improved water supply. These rural communities are likely to rely on water sources such as rivers, streams, ponds and unprotected wells; and in 80% of households without piped water, they rely on women and girls for water collection. Water from rivers, streams and ponds are susceptible to water borne diseases such as typhoid fever, cholera, dysentery, malaria parasites etc, and ultimately, unsafe drinking water, inadequate availability of water for hygiene, and lack of access to sanitation together contribute to about 88% of deaths from diarrheal diseases. While our world scrambles to think of innovative new ways to implement the World Health Organisation’s new guidance on hand hygiene to protect against Covid-19, we in Nigeria must remember that it is rural women who must be prioritised first. As the backbone of our country and the people most responsible for ensuring our sustenance from food and water, their access to handwashing resources is of utmost importance. What’s more: soap is not expensive, but a lack of soap is VERY expensive: it costs the world 134,147,060,000,000 Naira. It is time for Nigeria to invest in hygiene, and country-led programmes to accelerate progress and sustainable impact for the people who lack basic handwashing facilities. My Wellbeing Foundation Africa Mamacare midwives help remedy the issue in Nigeria by going deep into rural communities, health facilities and schools to ensure water, sanitation and hygiene. We call our dedicated interlocutors 'Sanitation Angels,' as they deliver key knowledge and best practice techniques at public and private primary, secondary and tertiary health facilities across Nigeria. Another organisation doing an amazing job aiming to reach rural women is ACWW, who is hosting a Survey on Living Conditions Of Rural Women, which I ask that you share with rural women in your life.  

FROM October 12th, 2020

The anguished scenes coming from our beloved nation Nigeria, of peaceful young protesters being forcefully dispersed, arrested and even injured and killed, are cause for sobering concern, even as many have noted the announcement that the SARS is to be immediately disbanded. The scenes speak to the state of the nation's wellbeing, and what affects one citizen, affects us all. The Economic and Social Research Council, which supports police reform in Nigeria, has assessed that between 2015 and 2019, over 40,000 lives were lost to violent crime, civil unrest and banditry, over 1,000 police officers died or were missing in the line of duty, over N600 billion Naira is estimated to have been lost to violent unrest and crime, while thousands of complaints have been filed to and by the police. Among those is a complaint regarding the molestation of a group of 70 women alleged to be sex-workers in Abuja in 2018 and 2019. That these women were treated by the authorities as less than human is at once a grave offense to their dignity and at the same time, an all-too-common occurrence. Our commitments and endorsement of United Nations Resolution 1325 specifically call for a reduction on violence against the female gender particularly because it is ultimately women and girls who bear the brunt in conflict. That our police system so blatantly flies in the face of internationally recognised orders that promote the healthy development of a country is antithetical to its purpose and existentially damaging to our nation's progress. It is poignant that yesterday was International Day of the Girl, and it was notable that I saw images of steadfast female activist Aisha Yesufu insist on social justice, and so many other young women rising to provide representation and relief. I see hope and practical expressions of loyalty to our nation's ideals in our women and youth. Our young citizens have made five requests of our nation's leaders:

  •  Immediate release of all arrested protesters
  • Justice for all deceased victims of police brutality and appropriate compensation for their families
  • Setting up an independent body to oversee the investigation and prosecution of all reports of police misconduct within 10 days
  • In line with the new Police Act, psychological evaluation and retraining (to be confirmed by an independent body) of all disbanded SARS officers before they can be redeployed
  • Increase police salary so that they are adequately compensated for protecting lives and property of citizens.
I urge decision-makers to listen to the voices and experiences of young citizens to chart a positive path forward in ending brutality, initiating reform towards restoring rights, civil liberties, safety, security and peace.

FROM October 11th, 2020

The empowerment of girls directly relates to their ability to obtain a quality of education, and ultimately, the rise of girls directly correlates with a nation’s ability to sustainably develop. 

On International Day of the Girl Child in the middle of the global pandemic which has seen the project of ensuring the systems to empower women and girls plummet, I am lending my voice to our equal future by celebrating girls' right to education. We must eliminate all forms of discrimination against girls and build the will of leaders to commit to a course of actionand an intentional and deliberate community of practicethat helps girls to rise, from respectful care from birth and the cradle, to productive and prosperous age. Girls face multiple challenges purely because of their age and gender. Around 62 million girls around the world have no access to education and less than 40% of countries provide girls and boys with equal access to education. From being denied an education to experiencing teenage pregnancies and being forced into child marriage, girls face a myriad of obstacles that prevent them from realising their full potential.  In Nigeria, 10.5 million of the country’s children aged 5-14 years are not in school, and in some states in the north, more than half of the girls are not enrolled in schools at all. With the impact of Covid-19, children who were already most at risk of being excluded from a quality education have been most affected. Girls are more likely to be pulled out of school to take care of the family at home during the pandemic, and studies have also found girls’ access to mobile internet is 26% lower than for their male peers. Researchers found that previous epidemics have forced more girls than boys to halt their studies, which impacted economic prospects for a generation of young women. Yet we know that when a girl is educated, she is enabled, empowered and engendered to realise her full potential.  This was why, in my subnational advocacy as the First Lady of Kwara State from 2003 to 2011, I had deliberately and historically made it a point of principle and action to lend my voice and effort in mobilising women's groups and cooperatives to advocate strongly for the retention of the girl child in education. I also advocated for the domestication and implementation of Child Rights legislation through the Kwara State Child Rights Law of 2007, the Kwara State Safe Maternity Services Law of 2010, a strategic partnership with NAPTIP to strengthen anti trafficking protocols, and the establishment of a framework to deliver universal health coverage through the Kwara State Community Health Insurance Scheme. By the time I hosted Nigeria’s first Child Rights Conference in 2010, it was clear that the results went deeper than benefits to education, health and societal wellbeing that earned Kwara State the UNICEF accolade of being "fit for a child,” as the first of Nigeria's 19 northern states to reach this ambitious standard. By 2011, Kwara State was not only recognised as the state whose girls were the oldest in the nation at their first sexual encounter, but also recorded over 35% of women in elective and appointive positions at federal and state levels, including several Senior Ministers of the Federal Republic of Nigeria, namely Amina Ndalolo, Halima Tayo Alao, Olufunke Adedoyin, and an ambassador, Nimota Akanbi. Nationally, I lent my voice, effort and resources to the successful passage of the Violence Against Persons Prohibition Law, the rights of women to inheritance, the Breastmilk Substitutes Law, legislation to protect students in tertiary institutions from sexual harassment , and raising an evidenced body of analysis to challenge a perplexing constitutional amendment aimed at treating a married minor as an adult for renunciation of citizenship. The journey has also registered disappointments, significantly, the failure of Nigeria’s Gender Equality and Opportunities Bill. Unsurprisingly, the effects of conflict and unrest have been sharply highlighted in Nigeria’s North-East since the 2014 abductions of the Chibok Girls, and many more victims of enforced disappearances, necessitating the development of a dedicated strategy for the prevention of sexual violence in conflict PSVI, in support of United Nations Resolution 1325 though engaging globally with the United Kingdom-France PSVI Consultations and UNWomen African Women Leaders Network, and regionally with the African Union and Ecowas Consultations.  Health and wellbeing are indivisibly intertwined with educational opportunities in powering a healthy, prosperous and productive future, so to raise a pipeline of confident girls, the percolation of tree-top advocacy must cascade to frontline grassroots action, thus My Wellbeing Foundation Africa knows that an expanded investment in girls’ education, in providing personal social and health education not only equips girls with skills and knowledge to grow and prosper, but it helps their siblings, family, and wider community to thrive as well. Girls who stay in school are more likely to support themselves, look after their health, avoid early marriage and early pregnancy and contribute more to society. That’s why one of the ways we support the Girl Declaration and a girls' right to education is through our primary schools and adolescent PSHE WASH program sessions. Our approach is unique: powered by the professional interlocutory capacities of our groundforce of professionally qualified community midwives, we work directly with schools and communities to help them create a better and healthier future for their children and themselves. While the confidence to initiate and cascade innovation may come from being fortunate to be born in circumstances where the opportunities to rise and thrive are guaranteed, I am encouraged that we can build a community of better practice for all. That notion is evocative of this picture of myself and two childhood friends from 1969, when we had just celebrated what the world now recognises to be a key milestone and measurement of development and demographic functionality: the age of 5 years. The milestone underscores the importance of the goal that every girl may survive and thrive, with her full complement of rights, to transform her future, and the collective rise of girls and women in our nation.    [caption id="attachment_1229" align="alignnone" width="768"] Left: Sefi Atta, author and playwright
Middle: HE Toyin Saraki
Right: Obi Okigbo, architect and artist[/caption] Today, Sefi Atta, to my left, (born January 1964) is a prize-winning Nigerian-American author, playwright and screenwriter, who qualified as a Chartered Accountant in England, a Certified Public Accountant in the United States, and holds a Master of Fine Arts in Creative Writing. Her books have been translated into many languages. Sefi was a juror for the 2010 Neustadt International Prize for Literature, and has received several literary awards for her works, including the 2006 Wole Soyinka Prize for Literature in Africa and the 2009 Noma Award for Publishing in Africa. In 2015, a critical study of her novels and short stories, Writing Contemporary Nigeria: How Sefi Atta Illuminates African Culture and Tradition, was published by Cambria Press. Also a playwright, her radio plays have been broadcast by the BBC and her stage plays have been performed and published internationally. Equally, Obiageli Annabel Zeinab Okigbo (born 1964 Ibadan), grew up in Nigeria until the age of 16. She continued her studies in Kent, then graduated from Oxford Brooks University with a BA in Architecture and pursued her post-graduate studies at the Architectural Association School of Architecture in London. She practiced architecture in London, Rome and Paris until 1994. In 1995 she moved to Brussels where she now lives. Expanding her reach into the visual arts, she began developing her work on a theoretical level through painting and has consequently exhibited in Nigeria, the United Kingdom, Dubai and Belgium including two major solo exhibitions in Lagos, 2003 and London, 2007. Obi is President of the Christopher Okigbo foundation which she established in 2005, which is tasked with researching and preserving the legacy of Christopher Okigbo, poet (1932-1967). These women are the exemplar that the female gender, given gender-equal and equitable opportunities, will rise. By investing in girls, every girl can be that example. With an eye for achieving all that we have set out for the United Nations’ Decade of Delivery, we must embed the notion and girl declaration that girls’ progress means Sustainable Development Goals’ progress. Before, during and after crises like the pandemic, we must stand with her: we must build a skilled girl force and support that girl force to be unscripted and unstoppable, and lend our voice to our equal future. On International Day of the Girl Child, and always, we must respect and protect her mind, her vision, her spirit. Empowered and educated, girls can do anything they set their minds to. Lets encourage girls to shape the world they want to live in, achieving generation equality, and our planet 50/50 goals, now and today.

FROM October 5th, 2020

This weekend, the Wellbeing Foundation Africa's MamaCare Antenatal & Postnatal Education Program's Whatsapp Maternity Support had the honour to be featured in British Vogue Magazine's Forces For Change October Edition about their work reaching every last mile to care and counsel mums, babies, and their families. I am so proud of their embracing the promise of technology to democratize access to accurate information from conception and the cradle, to age. MamaCare’s WhatsApp world is far from your typical online talkfest. It’s a safe space for pregnant women and new mums in Nigeria to connect, commiserate, congratulate, and voice their honest concerns — including the stuff deemed uncomfortable or taboo — knowing they can count on getting a prompt, accurate response in return. Our midwives, sometimes referred to endearingly as “Mama” by their group members, field questions about everything from breast feeding and nutrition to pregnancy sex and postpartum spotting. By harnessing the power of digital communication I believe that MamaCare will amplify its impact. What’s currently reaching 8,000 mothers a month, can soon evolve into well over 200,000. And with about seven million babies born in Nigeria each year and our goal of providing every single one of them and their families with a safe delivery and quality care, the new WBFA chatbot will be a major step in fast-tracking that ambition. Our tech is going to underpin our frontline. We want to be able to deliver lessons, immunisation reminders, nutrition advice, all by WhatsApp. If something as obtainable as WhatsApp has the capacity to improve medical outcomes for Nigeria’s most disadvantaged women through the diffusion of reliable information, then the world might not be as far from widespread healthcare reform as we once thought. As the developers of a wide range of home and health facilities based health records, the Wellbeing Foundation Africa believes that the role of data collation and analysis is crucial to the evolution of egalitarian healthcare systems. When we’re at a crossroads and we’re not sure what to do, data, if it’s openly and freely available, can lead us forward, hovwever we can’t access data if we’re not accessing the promise and realities of technology. I’m hoping that the WBFA’s use of technology will add this extra layer to all of our programming, and democratise it. Read more about my Forces For Change interview: WhatsApp Is The Key To Democratising Global Healthcare>>

FROM October 1st, 2020

During my childhood in the 1960's, I remember singing our Independence Anthem confidently in the affirmation that though our tribes and tongues may differ, we stand in brotherhood, proud to serve our sovereign motherland. Our flag is a symbol that truth and justice should reign, and our collective dream of being able to hand on to our children, a banner without stain, as we prayed to the Lord of all creation to grant our request to help us build a nation where no man would be oppressed, and so with peace and unity, Nigeria would be blessed.  Nigeria is 60 today, and we have much to celebrate: our indomitable spirit, our endurance, fortitude and resilience - and our hard earned unity. We have an unquenching optimism for progress, and I know that my motherland has come a long way from Independence Day on 1st October 1960 and the vision of our founding fathers till today. Reflecting on our nascent years I can declare that Nigeria was indeed blessed, albeit simply, with abundant natural resources to grow a healthy population and prosperous future for all. At the same time, agitation for equitable management of our abundant natural resources, and the resulting humanitarian crisis directed our first experiences of multilateralism. International donor agencies arrived to assist the suffering and displaced victims of our civil war, as the nation strove to heal its wounds. The multilateral agencies remain with us today, implementing key services towards the sustainable development goals, working alongside national and frontline organisations.  In those early formative years, lacking encounters with the basic day-to-day development challenges that shape creative public policy, our youthful nation paid little intentional and deliberate attention to the status of women and girls. We were so busy building our national unity, which at times was imperiled, that it didn’t occur to us to be intentional in our support for young women and girls to rise, even though culturally we have always revered and respected matriarchs and motherhood. This dichotomy has contributed to shaping some of the most dire realities of not meeting the needs of our women and girls that we as a nation face and experience today, where despite 50% of the electorate being women, the male gender occupies a disproportionate amount of cross-sectoral leadership positions.

This was why, as the First Lady of Kwara State in 2003 to 2011, I had deliberately and intentionally made it a point of principle to lend my voice and effort in mobilising women's groups and cooperatives to advocate strongly for the retention of the girl child in education and the domestication of Child Rights legislation through the Kwara State Child Rights Law of 2007, the Kwara State Safe Maternity Services Law of 2010, and the establishment of a framework to deliver universal health coverage through the Kwara State Community Health Insurance Scheme. The results went deeper than benefits to education, health and societal wellbeing that earned Kwara State the UNICEF accolade of being "fit for a child" in 2010, the first of Nigeria's 19 northern states to reach this ambitious standard - as by 2011, Kwara State had recorded over 35% of women in elective and appointive positions at federal and state levels, including several Senior Ministers of the Federal Republic of Nigeria, namely Amina Ndalolo, Halima Tayo Alao, Olufunke Adedoyin, and an ambassador, Nimota Akanbi.

Our present national reality is that Nigeria is the world capital for under-5 mortality and is among the top five countries with the highest maternal mortality rate. Though saving the lives of women and new babies will always evoke heartstring-pulling imagery, this is not merely a matter of compassion: this is a daily imperative and basic need for any country interested in sustainably developing. The safe transfer of life: from mother to child, and ensuring the health and wellbeing of both are preserved, is as key to socioeconomic development and economic growth as ensuring that families can access their rights and choice of reproductive intervals and size. A high level of maternal death means we have a lost population of women in the reproductive age: a youth and gender demographic that has been proven to be constructive for sustainable development. It also means we have a higher number of orphaned children and children without the benefit of the full family structure, a setup we know to be conducive to healthy lives. A high maternal death rate impacts women’s ability to participate in the labour force, which in turn decreases their ability to contribute to the economy. And, it consumes and hamstrings our budgets, and disables our ability to diversify our resources to other sectors for developmental purposes. 

The problems we face as a nation are a manifestation of the way in which we built our country, but today, at 60, and surely matured, we have an opportunity to catalyse an inclusive and cohesive course correction. We are centred on reiterating the national call to arise and serve our fatherland with love, strength and faith. We must reiterate that the labour of our heroes’ past shall never be in vain, and to serve our peoples with heart and might: one nation bound in freedom, peace and unity - to reach every last mile.

Right now, Nigeria’s Covid-19 deaths are comparatively low, and our nation’s endurance is high and strong; to me, possibly the product of a fortuitous resilience shaped by our long epidemiological history. However it is clear that the race to combat, contain and control Covid-19 is a marathon and not a sprint. According to The Economist’s Covid Collective Report, states like Nigeria are at risk of being “disproportionately affected because they have the least resources and infrastructure to grapple with the pandemic’s dire health and economic repercussions.” While richer countries are able to do more testing and prepare economic safeguards and recovery, Nigeria has recorded fewer tests per thousand people and has fewer resources to plan recovery.  Examples of collaboration among scientists, however, show that models for better cooperation are possible, and indeed a timely focus on home-grown research and development from Nigeria may yet have much to teach the world. Stronger frameworks and mechanisms for international cooperation are required to mitigate the adverse effects on lives and livelihoods globally, and in fragile settings in particular. The fact that 172 countries globally are engaged in discussions to participate in COVAX – a Covid-19 vaccine global access facility – demonstrates just how powerful global cooperation can be in finding collective solutions to collective problems. On our 60th celebration of independence, we reaffirm our patriotic call to direct our noble cause: that our leaders are guided right, our youth are helped to know the truth, grow in love and honesty, living just and true, attain great and lofty heights, to build a nation where peace and justice shall reign, a pledge to the progress of our nation. But we cannot deny that Covid-19 has laid bare fissures in the multilateral system with far-reaching implications. From climate change to economic recessions, geopolitical tensions to AI disruption, truly global challenges are only going to become more frequent in our increasingly-interdependent world. Every country is only as strong as the weakest link in the chain thus we know that the gaps in domestic and international safety nets are not just a threat to the world’s vulnerable populations but also to the functioning of the global economy and society as a whole.  As we celebrate the transformative power of patriotism, we must remember that no nation thrives entirely alone, and should work towards reviving multilateralism’s promise to ‘leave no one behind’ with particular focus on the effect of the pandemic on our most vulnerable women and girls. With the pandemic upending the world’s structural norms, Nigeria has an opportunity to come out of this dark time with a new energy based on the evidence of what works—and what does not work— to achieve our goals sustainably and for all. To meet the challenges of the 21st century, each and every one of us as individuals, along with our national governments, multilateral actors and humanitarian leaders must heed Covid-19’s wake-up call and unite to give multilateralism the “teeth” it needs to reform, replenish and strengthen national and global resilience both now and when the next crisis emerges, to ensure that our beloved nation Nigeria, and our people will survive, transform and thrive.

FROM September 26th, 2020

The biggest misconception about contraception in Nigeria is that contraceptives encourage promiscuity. The fact is, the education and economic empowerment of women directly correlates to their ability to plan, manage and thrive throughout their experience in the reproductive process.

So today on World Contraception Day 2020, I am leading the Wellbeing Foundation Africa in joining the WHO Department of Sexual and Reproductive Health and Research (including the United Nations Development Programme, the United Nations Family Planning association, UNICEF, the World Health Organisation and the World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP) along with organizations and individuals worldwide in celebrating this important event.

Contraceptive information and services are fundamental to the health and human rights for everyone. Access to safe, quality, affordable contraceptive information and services, together with the provision of fertility care, allows people to decide whether and when to have children, and also the number of children they would like. Ensuring access to preferred contraceptive methods for women and couples is essential to securing their well-being and autonomy, while supporting the health and development of communities.
My decades of work to improve maternal health contributes to the rise of women because in Nigeria, first and foremost there is a critical need for mothers to plan their families, and survive childbirth in order to allow them to thrive. That is the ethos that drives my work as UNFPA Nigeria's Family Planning Champion, as a co-author of the Lancet Maternal Health Series on stillbirth, as a commitment maker to FP2020 Movement and the International Conference on Population and Development ICPD25, and as a lifelong advocate for women's rights to contraceptives and family planning.

In November 2016, the 4th Nigeria Family Planning Conference in Abuja hosted the Africa regional launch of The Lancet Maternal Health Series. National and international health leaders joined me and my Wellbeing Foundation Africa for this important gathering, including the Honourable Minister of Health Isaac Folorunso Adewole, Professor Oona Campbell, author of the 2016 Lancet Maternal Health Series and Professor Oying Rimon, The Bill and Melinda Gates Foundation, The Challenge Initiative, the Bloomberg School of Public Health,  DFID UK, USAID, Plan International, Evidence For Action, The White Ribbon Alliance and NURHI, the National Council for Women’s societies NCWS, and YWCA, among many national stakeholders.

With insights shaped by co-authoring the previous 2015 Lancet Maternal Health Series: Stillbirths: Economic And Psychosocial Consequences – and having attended the initial launch of the 2016 Series report at the global stage to coincide with the 71st UN General Assembly in that September, I observed that The Lancet Maternal Health Series covers the epidemiology of maternal health, the current landscape of maternal health care and services in both high- and low-income countries, and laid out future challenges and strategies to improve maternal wellbeing.

Addressing stakeholders alongside fellow panelists Professor Oona Campbell who launched the Series, Professor Adinma, Dr Kole Shettima, Dr Tunde Segun and Dr Allisyn Moran with the discussion entitled: “What is family planning doing for maternal health in Nigeria,” – I welcomed the Nigeria launch of the 2016 series, which provided all stakeholders and policy-makers the evidence with which to guide concrete actions to improve maternal newborn child and adolescent health services.

The launch of the 2016 report coincided with the revised WHO guidelines which recommend that pregnant women in low and middle income regions receive eight antenatal visits, and increased recommendation from the four antenatal visits previously indicated within the WHO’s focused Antenatal Care policy. It vindicated and validated the Wellbeing Foundation Africa’s MamaCare Antenatal And Postnatal Skills And Drills Curriculum model for midwives and mothers, respectively.  It demonstrated that the provision of a midwifery-led continuum of care and counsel, along with universal access to high quality affordable health services through community health insurance, improved training in emergency obstetric and newborn care, underpinned by integrating its robust patient-custody health records with digital facility health records and civil registrations data skill-sets are, together, crucial to improving survival and wellbeing.
As Nigeria’s first civil society community midwives health visitor program, the Wellbeing Foundation Africa’s MamaCare360 Antenatal and Postnatal Education Classes incorporate a postnatal session where breastfeeding techniques are delivered to mothers along with informed family planning advice. We affirm that access to family planning information and contraception is a fundamental human right, empower women to decide when and where to have a child, and how many children they wish to bear according to their circumstances, and recognising those rights, we recommend that mothers space their childbirth by 1000 days to better sustain the health and socio-economic wellbeing of mother, child and family.

In 2016, Nigeria had cause to celebrate the then-recorded 40% improved survival rates delivered over four years through Nigeria’s Midwives Service Scheme, despite government challenges in sustaining state and local government traction on these gains – which are sorely threatened today. That's because Nigeria has once again, in 2020, overtaken India as the worlds capital of multi-dimensional poverty, malnutrition, and under-5 mortality.

Prior to the interrupted access to routine family planning services caused by the coronavirus pandemic, most low- and middle-income countries were on course to experience substantial economic growth, which will increase their fiscal space for health investments in maternal and newborn health. However, with the expected surge in 'lockdown pregnancies' we must ready ourselves to harmonise and standardise the wide variations within quality of care, between two broad scenarios which reflect the landscape of poor maternal health care – the absence of timely access to care (defined as ‘too little, too late’) and over-medicalisation of normal antenatal, intrapartum, and postnatal care (defined as ‘too much, too soon’) - and the submerged social determinant factors of economic distress, and co-related domestic and gender-based violence.

Yet we know the steps to take to recapture early successes:
  • The National Task-shifting Policy: When community health workers were allowed to administer injectable contraceptives, the uptake of family planning in hard-to-reach areas went up dramatically. That success was irrefutably demonstrated in Nigeria.
  • It will be hugely beneficial to improve clarity on Nigeria’s currently confusing ‘dual-qualification nurse-midwife’ overlap, to provide clear distinctions between the midwifery qualification, and the general nursing qualification, applying the learning from the WHO Midwives Voices Midwives Realities Report, which documents the voices and realities of 2,470 midwifery personnel in 93 countries and describes, from their perspective, the barriers they experience to providing quality, respectful care for women, newborns and their families.
I urge our Federal Government and policy makers to consider:
  • Integrating the International Confederation of Midwives’ Midwifery Services Framework into Nigeria’s public health policy as the best practice model to strengthen midwifery services to deliver the full complement of maternal and newborn care, including family planning.
  • To honor their FP2020 commitments to improving family planning funding and services
  • To partner with donors and other non-governmental organizations to increase financing for family planning at all levels
  • To strengthen primary health care facilities to provide family planning counseling and services for increased access and improved coverage
  • To partner with non- governmental agencies and development partners to build the capacities of healthcare providers across all cadres to encourage task shifting/sharing to overcome human resource constraints
  • To strengthen country’s forecasting capacities and supply of family planning capacities
  • To adopt innovative approaches such as community-based family planning services, involvement of men, traditional and religious leaders as family planning champions to break religious-cultural barriers
  • To continuously create awareness on family planning for women and families to make informed decisions on birth spacing.
  • To scale up deployment of patient custody health records and facility and health-worker driven digital records databases to provide real-time transparent and accountable community audit mechanisms in measuring public health services delivery

Poverty, inequality, and geographical barriers all clearly play out in maternal health where both our challenges and opportunities abound.

We should, therefore, guarantee that every woman, everywhere has access to quality care. An essential part of advancing maternal health in Nigeria is accelerating, reinforcing and replenishing the progress of family planning education and services to all women, thus preventing unwanted pregnancy. It is true that women, families and communities need births to grow, yet it is unethical and simply unacceptable to encourage women to give birth in places with low facility capability, with unskilled providers, or where the content of care is not evidence-based. This failing should be remedied as a matter of priority.

To achieve the 2030 SDG global target of a maternal mortality ratio of less than 70 per 100,000 live births, we must prioritise quality maternal health services that respond to local needs; promote equity through universal coverage of quality maternal health services; improve the health workforce and facility capability; guarantee sustainable financing for maternal and perinatal health; and generate better evidence, advocacy, and accountability for progress.
The Wellbeing Foundation Africa’s Mamacare+Nutrition program which sub-implements the Nutrition International and UNFPA NLift Strategy though the Wellbeing Foundation Africa MamaCare Community Midwifery Program, improves maternal education, family planning and nutrition through iron and folic acid supplementation, supported by Global Affairs Canada, currently reaching 11,000 women at 60 Health Facilities and their surrounding households and Ward Development Committees in the Federal Capital Territory, Abuja.

FROM September 18th, 2020

The numbers are stark:

Women make up 70% of the global health workforce, but only 25% of global health leadership. That is primarily because midwives and nurses make up nearly 50% of the entire global health workforce, and midwives and nurses are over 90% women. Yet only 13% of CEOs in the global healthcare workforce are women. It is said that unlike other sectors, healthcare does not have a “woman problem,” rather, it has a “women in leadership” problem.  At the same time, there is a global shortage of health workers, in particular nurses and midwives, who represent more than 50% of the current shortage in health workers. And as Africa’s most populous country, Nigeria has one of the largest stocks of human resources to employ in healthcare, but it does not have enough people—women or men—working in the healthcare sector to support its population. At 1.95 per 1,000 people, Nigeria’s density of nurses, midwives and doctors is too low to deliver essential health services, which ultimately contributes to the abysmal state of its healthcare system. With the impact of coronavirus bringing global health systems to a halt, the prolonged lack of investment and systemic issues in Nigeria have compounded its vulnerabilities. This scenario makes the African continent susceptible to becoming the new epicentre of the disease.

To increase the number of health workers in Nigeria and improve on the number of women in positions of leadership in healthcare, we must build a progressive pipeline of confident girls, and support systems to remunerate healthcare workers properly, and build resilient healthcare systems in Nigeria. 

One way I’m working on supporting confident girls is through my organisation Wellbeing for Women Africa, which amplifies the voices of young African girls, by paying a global network of Youth Partners (currently we have 63 YPs from 18 countries) microgrants to write about their perspectives on the most pressing social issues of our time. For instance one YP recently released a study called Wa Wimbi, which demonstrated evidence that regardless of the sector, women continue to face discrimination and they are unable to progress due to gender barriers. The organisation aims to give young women a platform and in that way, a seat at the decision making table to ultimately allow them control over their own future. Because we know that girls’ learned lack of confidence is a barrier to their success later in life, ensuring that girls understand that their voice is important, their viewpoints are valid and that their perspective is not just interesting but worthy of remuneration, is one small way in which we can build a pipeline of women leaders. At the same time, there is an endless need for leaders in the public and private sectors to come together to figure out solutions for better recognition, regulation, respect and remuneration for health care workers in Nigeria in the interest of building that pipeline of healthcare workers in the country. My advocacy on this issue goes from strength to strength as Inaugural Goodwill Ambassador for the International Confederation of Midwives, to my membership of the Concordia Leadership Council, and it’s not an issue that is easily solvable or that can be explained with pithy phrases. It’s going to take international collaboration and years of governmental support to create a resilient system that can hold up over generations. One successful approach to increasing the number of midwives in our country was the Midwifery Service Scheme, established with the help of my Wellbeing Foundation Africa, which mobilizes unemployed and retired but able midwives and newly qualified graduates from Nigerian Schools of Midwifery to rural communities for one year of community service. As I recently noted, best practices identified under the scheme need to be reactivated and consolidated nationally. Within the Wellbeing Foundation Africa, we have seen, recorded and measured the value and sustained impact of placing a highly skilled midwifery workforce at the front, centre and heart of our communities-focused cradle-to-age programming, as coaches, educators, interlocutors, advocates and leaders, as the delivery centrifuge of our unique yet seemingly simple MamaCare Antenatal and Postnatal, SRHR, Nutrition, SGBV PSHE and WASH programs - and the results are crystal clear. Activating, actioning and tracking accurate information regularly through respectful and compassionate compassionate multi-directional conversations engender transformational social behavioural change and trusted learning, which together with deploying data for good, embeds key resilience into our community of best practice, improving the quality of care and lives. The fact remains that we must attract, employ, retain, remunerate and support healthcare workers by giving a powerful leadership path incentive: healthcare in Nigeria must be made a good career choice. A recent Institute of Economic Affairs report makes the case that Nigeria could do more to partner with high-income countries to secure investment, and do more to attract global investors and international financial institutions to finance their healthcare systems. For healthcare workers to want to stay in Nigeria, they must be supported by better working conditions, training, equipment, and insurance related to workplace risks, and remuneration.  Another way I’m working on this is by ensuring healthcare workers are properly trained. My Emergency Obstetric and Newborn Care Training Programme, or EmONC, is a ground-breaking partnership between the Wellbeing Foundation Africa, Johnson & Johnson and the Centre for Maternal and Newborn Health (CMNH) at Liverpool School of Tropical Medicine. The partnership focuses on EmONC training in healthcare facilities to improve health outcomes for mothers and their newborns, and it has seen 80% of all maternal deaths result from five complications which can be readily treated by qualified and trained health professionals. EmONC training is so successful because it takes place in-house and equips doctors, nurses and midwives, as a collective team, with the skills needed to overcome these obstetric emergencies, in an accelerated knowledge pathway from research bench to bedsides at the multi-tiered facilities most in need. The results again are clear, the state in which we have pioneered this training and achieved program saturation has the enviable status of the lowest preventable maternal and child deaths in the nation, informing my advocacy insistence of a push into the national health strategy, at scale. At the same time, the Institute of Economic Affairs’ report states that “African countries spend more on paying interests on external debts rather than on public healthcare.” It’s a fact that needs to change, and it can change only by way of leadership from the state and local governments, by ensuring our systems can properly fixate systems underpinned by rightly targeted budgetary planning and fiscal appropriations that invest public funds equitably back into the health of our own people to deliver accessible, affordable health care.

FROM September 15th, 2020

I am deeply concerned by the recent findings that Nigeria has overtaken India as the world capital for under-five deaths, according to the UNICEF report 'Levels and Trends in Child Mortality,’ particularly as we had previously seen significant improvements in Nigeria between 1990 and 2015. This distressing news comes just as we congregate virtually this year for the United Nations General Assembly. The report compiles data spanning three decades from 1990 to 2019, and it reveals that 49% of all under-five deaths in 2019 occurred in just five countries: Nigeria, India, Pakistan, the Democratic Republic of Congo and Ethiopia. It finds that Nigeria and India alone account for almost a third of the deaths, and what is evermore worrying is that it is clear that there is a strong potential of a continued mortality crisis in 2020 with the additional strain of the coronavirus pandemic.

I have always felt that if the nation is truly committed to the daily goal of ensuring that our women can give birth safely to babies that can survive and thrive from the cradle to age, we must strengthen and build resilience in our frontline health care services. 

Our primary health care services must be supported beyond bricks and mortar to encompass the full range of quality affordable health care provided by a well equipped, well skilled and adequately remunerated health workforce, who are motivated to deliver respectful maternity and child health care and advice. We must intensify our efforts to engender, enable, empower, replenish and reinforce the capacities of the most appropriate and qualified health professionals to stand with women and their families as a central core focus which will be validated, vindicated and reinforced throughout this Year And Decade of the Midwife and Nurse. We must build resilience within our healthcare system. In my opinion the significant 35% aggregated gains and improvement in maternal and child survival measured between 2010 and 2015 across Nigeria, which is now gravely threatened, was catalysed by the roll-out of the simple yet revolutionary Midwives Service Scheme (MSS), launched in 2009 by the National Primary Health Care Development Agency (NPHCDA), in 2009 during the administration of late President Umaru Yar Adua. It aimed to address the challenge of Nigeria's very poor record regarding maternal and child health outcomes. An estimated 53,000 women and 250,000 newborns were dying annually mostly as a result of preventable causes. The NPHCDA was tasked with establishing the MSS as a public sector initiative and a collaborative effort between the three tiers of government in Nigeria. A memorandum of understanding between the Federal, State and Local governments set out clearly defined shared roles and responsibilities, which were supported by the Wellbeing Foundation Africa and other strategic partners. The MOU was signed by all 36 states of Nigeria and was designed to mobilise newly qualified, unemployed and retired midwives for deployment to selected primary health care facilities in rural communities and facilitate an increase in the coverage of Skilled Birth Attendance (SBA) to reduce maternal, newborn and child mortality. The MSS Technical Working Group (TWG) met regularly to receive updates, review progress and advice in order to provide strategic direction, support and guidance for the implementation of the MSS. The secretariat of the MSS was responsible for day-to-day management, whilst state focal persons served as contact people for the midwives in the MSS. The MSS was based on a cluster model in which four selected primary healthcare facilities with the facility to provide Basic Essential Obstetric Care (BEOC) were clustered around a General Hospital with capacity to provide Comprehensive Emergency Obstetric Care (CEOC). Qualified professional midwives were deployed to each selected PHC, ensuring 24 hour provision of MNCH services and access to skilled attendance at all births to reduce maternal, newborn and child mortality and morbidity. The MSS pilot then covered 163 clusters, which had 652 PHCs and 163 general hospitals. The MSS strengthened the PHC system by distributing basic equipment (midwifery kits, BP apparatus etc, and a comprehensive civil registrations and vital statistics data capture system including partographs, to all facilities, in the form of the IMNCH Personal Health Records and Home-Based Records, developed by the Wellbeing Foundation Africa) to 652 facilities through the vaccine logistics system. The MSS was successful in establishing and reactivating ward development committees WDC's at all MSS PHCs to ensure community participation and ownership in its implementation. The outcomes were impressive and immediately impactful: 2,488 midwives were successful in applying to the MSS and were deployed to PHC facilities. The midwives from all over Nigeria were then given an orientation which I was pleased to host, as a member of the Critical Core Committee of the FMOH to upskill and familiarise them with the scheme. As of July 2010, 2,622 midwives had been deployed to PHC facilities in rural areas. MSS provided capacity building by the creation of a training framework, which was aimed at improving the skills and proficiency of midwives in provision of quality maternal and child health services. The midwives then underwent competency training through Principals of Schools of Midwifery. The MSS planned to implement information and communications technologies support to improve communication and articulated a monitoring and evaluation framework for the scheme.  Partners, including the Wellbeing Foundation Africa, committed to initiating and implementing a two-pronged approach to programme communication: it focused on political leaders and decision makers, as well as clients, through radio, TV, billboards, community outreach, and health centre branding to ignite social and behavioural change and demand creation for health-seeking and health providing orientation. The MSS faced (and still faces) five key challenges, namely: 1) implementation of the Memorandum of Understanding, 2) availability of qualified midwives, 3) retention of midwives, 4) capacity building of midwifes and 5) sustenance of linkages. There needs to be more support and commitment from officers in relevant government departments, which can be achieved by ensuring clarity on the objectives and aim of the MSS. Over the years, several initiatives and programmes had been introduced to reduce mortality among mothers and children in Nigeria. Despite these efforts, poor maternal and child health indices had continued to be one of the most serious development challenges facing the country. Significant progress was accomplished in the implementation of the MSS initiative however and the best practices identified under scheme need to be reactivated and consolidated nationally, with a view to overcome challenges. Despite the dire recent national indices, which were not entirely unexpected given the stoppage of the original MSS and its replacement with an eponymous but less focused model, I remain encouraged to redouble my institutional efforts for maternal and child survival. I am encouraged by the fact that Kwara and Lagos States, where my Wellbeing Foundation Africa has achieved and maintains significant programmatic scale, are now consistently recorded as having the two lowest preventable mortality rates in Nigeria respectively, while Kaduna State and the FCT Abuja where we also work have shown significant improvements. These gains highlight the importance of the WBFA's midwifery-led direct frontline action models which deliver our MamaCare Maternity Education, EmONC Healthworker Training, WASH for Wellbeing and Hygiene in Health Facilities, Child and Adolescent PSHE WASH In Schools, and Alive&Thrive Maternal Infant and Young Child Feeding and Nutrition programs.  In tandem, we support strong accountability frameworks that can hold governments to account on their health commitments to drive a policy continuum of health for all. Mindful of the fact that we have only ten years to accelerate actions towards our 2030 Sustainable Development Goals, the Wellbeing Foundation Africa is energised by the WHO and multi-lateral agencies’ commitments to pursuing stronger collaborations for better health. In addition, we commit to strengthening deliberate sexual and reproductive health and gender programming and women's leadership, with the simple premise that stronger collaborations contribute to better health. This Global Action Plan for healthy lives and wellbeing for all, will promote, engage, accelerate, align and account for purposeful, systematic, transparent and accountable primary health care. It will create sustainable financing for health, community and civil society engagement, improve determinants of health, invest in innovative programming in fragile and vulnerable settings and for disease outbreak responses as well as research and development, innovation and access, data and digital health.  In promoting better leadership at global, regional and country levels, stronger collaboration is the path, but better health is the destination. If the nation cares to ensure women can give birth safely to babies that survive from the cradle to age, we MUST strengthen frontline health care services, immunisations, nutrition and WASH - I hope that the community of best practice we have developed and implemented towards healthy lives and wellbeing for all, from birth to age may cascade its impact across my nation Nigeria, Africa, and the world.

FROM September 11th, 2020

This week, my Wellbeing Foundation Africa's partners at Amref Health Africa led an excellent session - "A Health Accountability Framework, Holding Governments Accountable for their Health Commitments” . I warmly welcomed the discussion of the importance of supporting strong accountability frameworks, such as the Right to Health Index, that can hold governments to account on their health commitments. The Right To Health Index is grounded in the recognition that health accountability needs to move away from using general statistics and focus instead on identifying specific indicators for use in human rights. In doing so, accountability frameworks can facilitate the realization of health as a human right and universal health coverage for all. Health as a human right has always been central to The Wellbeing Foundation Africa’s work, particularly the infusion of poverty alleviation, rights and gender-based programming into the WBFA's Alaafia Universal Health Coverage Scheme Fund in partnership with the PharmAccess Foundation and Hygeia Community Health Plan.   The Fund, supported the Kwara State Health Insurance Scheme established since 2007 by advocating for the 2012 and 2017 enabling state health insurance legislation, and by directly providing yearly capacitation fees for 5000 pregnant and newly delivered women, as well as adolescents, people living with HIV/AIDS, and elderly beneficiaries annually, within it's over 100,000 enrollees from 2015 onwards. Certainly, this availability of quality affordable care has contributed in no small measure to Kwara State maintaining its status as the state with the lowest maternal and under-5 mortality in Nigeria, at a time when the nation has been confronted with the unfortunate fact of having overtaken India as having the highest and worst preventable deaths of mothers and their young children globally - underscoring the importance of sustaining focused efforts across all 36 states of the federation to arrest this devastating trend of neglect.     https://www.youtube.com/watch?v=lVfErQTKH6Y&feature=youtu.be H.E. Senator Dr Abubakar Bukola Saraki, MBBS, CON, 13th President of the Senate and Chair, 8th Session National Assembly, Federal Republic of Nigeria, Former Kwara State Governor and Chair, Nigeria Governors Forum, at the Scale Up Ceremony of Kwara Community Health Insurance Scheme, Afon, Kwara State, 2009 I was also delighted to learn this week that the health insurance scheme has been recently re-launched with a target of 10,000 more mandatory enrollees. I heartily commend the PharmAccess Foundation and other partners for their focused tenacity in ensuring that the exemplary health insurance-driven universal health coverage model that all partners worked so hard to create and innovate, driven by the mutual vision of H.E Dr Abubakar Bukola Saraki  and the late acclaimed global health expert and medical research scientist Joep Lange to render affordable quality health care for all will continue to support and benefit many more people into the future. [caption id="attachment_1199" align="aligncenter" width="603"] Wellbeing Foundation Africa, Hygeia Community Health Plan, Pharmaccess Foundation, World Bank Nigeria, Federal Ministry of Health at Alaafia Universal Health Care Scheme Fund Conclusion Breakfast Meeting, Abuja, Nigeria, January 2017[/caption]

FROM September 2nd, 2020

Road safety in Nigeria is both a global health issue and a matter calling for focused national concern: road traffic accidents are the leading cause of death in adolescents in Nigeria. More broadly, there has been an upsurge in the proportion of traffic fatalities witnessed in a number of developing countries while developed nations are witnessing downward trends. 

That is why I welcome the United Nations General Assembly and member states in passing an historic resolution endorsing the “Stockholm Declaration”, aiming to improve and save lives on the world's roads, today. Nigeria has the second largest road network in Africa, and our latest figures show that Nigeria is among the top 50 countries with the highest road traffic deaths. According to the NRSS, population-road ratio was estimated to be 860 persons per kilometre roadway while vehicular density stood at about 39 vehicles per kilometre roadway. Nigeria recorded 337,301 road traffic crashes from 1990 to 2012, out of which 28.6% were fatal, 44.7% were serious, and 26.7% were minor. The overwhelming majority of road traffic deaths and serious injuries are preventable and, despite some improvements, they remain a major public health and development problem that has broad social and economic consequences which, if unaddressed, may affect progress towards the achievement of the Sustainable Development Goals (SDGs).  While each country has primary responsibility for its own economic and social development, the role of national policies, priorities and development strategies cannot be overemphasized in the context of reaching the SDGs. At the same time, international public finance plays an important role in complementing the efforts of countries to mobilize public resources, especially in the poorest and most vulnerable countries with limited domestic resources. I acknowledge the work of the UN system, in particular the leadership of the World Health Organization, in close cooperation with the UN regional commissions, in establishing, implementing and monitoring various aspects of the Global Plan for the Decade of Action for Road Safety 2011–2020. I recognize the commitment of the United Nations Human Settlements Programme (UN-Habitat), the United Nations Environment Programme, the United Nations Children’s Fund and the International Labour Organization, among other entities, to supporting those efforts as well as that of the World Bank and regional development banks to implement road safety projects and programmes, in particular in developing countrie.  I hope that this historic resolution will encourage all Member States to promote multi-stakeholder partnerships. I point to my Wellbeing Foundation Africa’s anatomical simulation training techniques that aim to improve health workers’ skills to address the safety of vulnerable road users, the delivery of emergency care and first aid to victims of road traffic accidents. Notably, this must happen more aggressively in developing and least developed countries, and we must provide road traffic crash victims and their families with universal access to health care in the pre-hospital, hospital, post-hospital and rehabilitation and reintegration phases. In addition, I will do my part to raise funds to bring in the right equipment for road accident trauma training. I must particularly commend the leading role of Oman and the Russian Federation in drawing the attention of the international community to the global road safety crisis. And, I must congratulate the Member States that have taken a leadership role by adopting comprehensive legislation on key risk factors, including the non-use of seat belts, child restraints and helmets, the drinking of alcohol and driving, and speeding, and drawing attention to other risk factors, such as low visibility, medical conditions and medicines that affect safe driving, fatigue and the use of narcotic drugs and psychotropic and psychoactive substances, mobile phones and other electronic and texting devices. With the lessons learned from the Decade of Action for Road Safety 2011–2020, the Global Development Community recognises the need to promote an integrated approach to road safety such as a safe system approach and Vision Zero. We must pursue long-term and sustainable safety solutions, and strengthen national intersectoral collaboration, including engaging non-governmental organizations, civil society and academia, as well as businesses and industry, which contribute to and influence the social and economic development of countries. I hope that state and non-state actors and policy makers will commit to prevent road traffic injuries, while I appreciate the WHO and its Director-General, Dr Tedros Ghebreyesus for its role in implementing the mandate conferred upon it by the General Assembly to act, in close cooperation with the UN regional commissions, as a coordinator on road safety issues within the UN system. Providing basic conditions and services to address road safety is primarily a responsibility of governments. This is especially in view of the decisive role that legislative bodies can play in the adoption of comprehensive and effective road safety policies and laws and their implementation. However I recognize nonetheless that there is a shared responsibility to move towards a world free from road traffic fatalities and serious injuries and that addressing road safety demands multi-stakeholder collaboration among the public and private sectors, academia, professional organizations, non-governmental organizations and the media. That is why I acknowledge that increasing road safety activities and advocating increased political commitment to road safety, will require working towards setting regional and national road traffic casualty reduction targets, elaborating global road safety-related legal instruments, including international conventions and agreements, technical standards, resolutions and good practice recommendations. It also requires domesticating and servicing 59 global and regional legal instruments that provide a commonly accepted legal and technical framework for the development of international road, rail, inland water and combined transport, to strengthen Nigeria's national road safety management capacity. As we approach the end of this Decade of Action for Road Safety, and start on the relevant road safety target dates set out in the 2030 Agenda, Nigeria must deepen national engagement with the new 2021-2030 time frame for a reduction in road traffic deaths and injuries. To push forward in the Second Decade of Action for Road Safety, with a goal of reducing road traffic deaths and injuries by at least 50% from 2021 to 2030, I support the call upon Member States and stakeholders to continue action through 2030 on all the road safety-related targets of the SDGs, including target 3.6, in line with the pledge of the 2019 High-Level Political Forum on Sustainable Development convened under the auspices of the General Assembly. We must especially take into account the remaining decade of action to deliver the SDGs by 2030 in their entirety.

FROM August 25th, 2020

Today is the day we have set our sights on for decades. Because of years of work by health workers on the ground, with the support and collaboration of international nonprofits, national and local governments, and with the weight of the world’s attention, we are able to celebrate this momentous achievement: Africa is wild polio-free.

I am overjoyed that today, thanks to 25 years of coordination and commitment by the World Health Organization (WHO) and the World Health Organization Regional Office for Africa (WHO-AFRO), wild poliovirus no longer threatens our children and future generations of children across the African continent. The achievement is all the more remarkable as the result of an instrumental campaign to vaccinate children in Northern Nigeria, a region that is choked by terrorist extremist rule. As of today, Africa is the fifth of six global regions to be officially declared wild poliovirus-free; with cases of the virus now found only in the eastern Mediterranean region. This milestone has been achieved through successfully scaling up and sustaining the delivery of vaccines to children in the hardest-to-reach places throughout Africa.   My Wellbeing Foundation Africa has proudly supported the communities we work with to detect, interrupt, and eliminate the wild poliovirus, alongside our global and national partners. Our programmes give mothers access to information on the safety and importance of vaccines, and our Personal Health Records are now a necessity in order to empower them to make immunisation choices in the best interests of their children. Now, thanks to the tireless efforts of so many working to ensure polio vaccines reach the most remote corners of the world, more than 18 million children who would have faced polio paralysis in the past are walking freely towards healthy futures. As the COVID-19 pandemic continues to disrupt health services, damage health systems and burden health workers, it is imperative that we come together globally, again, to address the public health challenges of the future. We must strengthen routine immunization programs in Nigeria, specifically to achieve full eradication of all forms of polio, including circulating vaccine-derived poliovirus, which remains prevalent in areas with weak or partial immunization coverage. To build on this enormous success, we must sustain our commitment to mass immunization campaigns, and we must do more to stop dangerous misinformation from spreading. Today marks a truly momentous milestone. My Wellbeing Foundation Africa offers our deepest congratulations and respect to the heroic health workers, community leaders, and volunteers who have contributed to this tremendous success. Congratulations, Africa!

FROM August 11th, 2020

The lived experience of Riskiat, the blue-eyed woman from Kwara state, underscores the need for economic empowerment to also tackle unconscious bias and gender discrimination.

  Riskiat Abdulazeez and her daughters grabbed headlines and pulled heartstrings in Kwara state last week when she spoke out with a distressing story about being abandoned by her husband and rejected by his family. The 30-year-old mother of two was left alone to afford food and education for her children, all because of a scepticism surrounding her distinctive pale blue eyes.  When I studied Riskiat’s story, what struck me was not just the unique (and beautiful) colour of the eyes: it was the fact that her life story is that of a typical woman in Nigeria—a story that so many of the United Nations’ goals and resolutions aims to target, support and empower.  She was a girl child who had every hope, but encountered every barrier.  [caption id="attachment_1183" align="alignnone" width="640"]Riskiat and her children Riskiat and her children accepting the donation from the Wellbeing Foundation Africa[/caption] As a child, Riskiat went to primary and secondary school, but didn’t sit her final examinations because her parents could not pay the fees, as she explained to PUNCHNG. Instead, her parents enrolled Riskiat in an apprenticeship, and following the apprenticeship, she worked in a shop where she met her husband, Abdulwasiu, in her early 20s.  After courting for a year, Riskiat and Abdulwasiu married, and Riskiat quickly gave birth to three children: five-year-old Kaosara and one set of twins, two-year-olds Hasanat Kehinde and Taiwo. The daughters, Kaosara and Hasanat Kehinde, inherited Riskiat’s distinct eye colour, while Taiwo, the son, had traditional brown eyes. The family lived together in Abdulwasiu’s family home, and Abdulwasiu, a vulcaniser, struggled to support the children’s diet and education, particularly as the COVID-19 pandemic brought Nigeria to a halt. It is clear through Riskiat’s interview that Abdulwasiu’s family was distrustful of Riskiat already—but the trigger point that led to the family breakdown happened when the male twin, Taiwo, fell ill earlier this year. As Riskiat illustrates in PUNCHNG, the family could not financially support his care, and ultimately, Taiwo died from his illness. The grief and devastation eroded the family’s cohesion even further: distraught because of the loss of his son, poverty-stricken and pressured by his family’s scepticism about the fact that Riskiat and the blue-eyed daughters had survived, Abdulwasiu instructed Riskiat to move out of his parents’ home. “He told me that his parents said they could not live with children with blue eyes. My husband also said his parents told him to marry a woman that would produce children with normal eyes,” she told PUNCHNG. We have always known that unplanned point-of-care medical expenses can throw families into poverty, but Risikat’s story shows us the devastating effect that unavailability of medical coverage can wreak. It impacts lives negatively far beyond the original community coverage aims of health for all. What Riskiat has yet to experience is self-sustaining autonomy via her own economic empowerment. As a child she was barred from further education because her family could not afford the fees. As a young adult, she attempted to make a living for herself, but instead married young and then struggled to feed, educate and protect her family because she relied on her husband, who could not support them. At 30, Riskiat has fire in her belly and light in her blue eyes: she insists that she does not want her husband back, and is steadfast in her interest in finding the best path forward for her children.  “God who created us has plans for every individual. I don’t have any specific thing (planned) for her and her sister. I only wish that they would become great in future” she said to PUNCHNG.   [video width="848" height="480" mp4="https://toyinsaraki.org/wp-content/uploads/2020/08/WhatsApp-Video-2020-08-08-at-2.25.56-PM.mp4"][/video]   Riskiat’s inability to control and plan her own life is the story of many women just like her, particularly in Nigeria. Country-wide, at age 20, less than 4% of men are married, compared to about 50% of women in rural areas. In some areas, around 40% of girls are married and 11% give birth all before age 15, which robs them of their educational attainment, career mobility and earning power, and makes them vulnerable to dangerous pregnancy complications like fistula. Moreover, we know that when we invest in women and girls, they invest in everyone else around them. That’s why I was not surprised to read that Risikat took a decision to sell her small patent medicines shop to raise the resources to feed her family during trying times. Women typically invest a higher proportion of their earnings in their families and communities than men. Women’s economic participation and ownership of their own finances helps overcome poverty and improves children’s nutrition, health, and school attendance.  Reading about how Risikat lost her twin son Taiwo, due to not being able to afford the necessary medical care in Kwara State in 2020, shocked my core beliefs, advocacy and actions regarding universal health coverage. From 2007 to 2016, my Wellbeing Foundation Africa’s Alaafia Universal Health Access Fund had supported the Kwara State Government in its partnership with Hygeia and the Pharmaccess Foundation, in launching the Kwara Community Health Insurance Scheme (CHIS), providing a comprehensive package of healthcare to all indigenes, and mitigating the economic devastation of unplanned point of care expenses with a record-breaking and prize winning low capacitation fee recognised as recently as 2012, 2014 and 2015. The Kwara State CHIS was renamed KwaraCares in late 2018, and shockingly, was inexplicably not accessed or not available to Risikat and her children in 2020 despite its strongly vociferous media presence. So when I intervened in Riskiat’s situation with a token donation for her children’s education, it is not just because of compassion for a woman and children with striking eyes. It is because a small investment in Riskiat—allowing her basic economic empowerment, and the ability to make her own autonomous choices for her life and that of her children independently—has the potential to stop a cycle of disempowerment and negative dependency that Riskiat and so many others experience. Alongside making the donation, I also immediately requested that the eminent Professors of Medicine at the long renowned University of Ilorin Medical Centre of Excellence and Teaching Hospital respectfully offer the family full medical screening, as the striking beauty of their blue eyes aside, it is not unusual for cases of ocular albinism to be associated with rare genetic conditions. I made this donation and medical referral as I continue to advocate that public health and education policies must deliberately, intentionally, and accountably replenish resources. They must reinforce learning and knowledge and embrace gender-data statistical values in managing pro-poor innovations and universal health coverage, to put people first, particularly women, newborns and girls, and leave no one behind, particularly in Kwara State where the Wellbeing Foundation, stakeholders and non-governmental organisations continue to work so hard and long to deliver the lowest under-5 mortality in the land.  

FROM July 22nd, 2020

I am overjoyed to receive a photo and update from a Wellbeing Africa Foundation mum today, and I must share the story.

In 2017, Mrs O was pregnant with triplets, and had been a student of my #Mamacare360 program. She needed, but couldn't afford a Caesarean, and the hospital just kept her waiting. The hospital was ready to abandon them. I have always advocated for socio-economic birth preparedness within universal health coverage, but birth waits for no-one, so I dashed there to help immediately. That's because a sound anti-poverty strategy should not only aim to increase incomes, but also provide the poor with a variety of assets — personal, social, political and environmental to help them overcome the myriad of challenging circumstances. ⁣ Sometimes being there for the right person, with the right help, at the right place, can change a life (or in this case, three more lives) way beyond the original aim of poverty alleviation. ⁣ Here is a photo of the absolutely beautiful triplets today: they have grown so big and strong, and it has made a sunny day today even brighter. [caption id="attachment_1178" align="alignnone" width="300"]Triplets The triplets, 2020[/caption]

FROM July 21st, 2020

A few weeks ago, I read an absolutely harrowing story of abuse in Akwuke, near Enugu City, Nigeria, and it has been on my mind ever since. I am consumed by the fact that its graphic nature and intimate impact were entirely preventable, if only the right systems were in place.

Early in June, a wife and mother of two young boys—we will call her Mrs. K—asked her husband for money to prepare food for the family. He had a history of violence, and he lashed out about the inquiry: when she proceeded to make pap for her 3-month-old baby, he doused her breasts in boiling water. She reacted in the throes of excruciating pain, and also unable to breastfeed her baby. The Women’s Aid Collective (WACOL) posted the story on Twitter, including graphic photos that I am choosing not to continue to publicise. WACOL has confirmed that the husband is now in police custody, but the psychological, emotional and physical damage to Mrs. K and her children has been done, and it is on us to use this case as a calling to rethink how we are handling the scourge of domestic violence in Nigeria.

The story is the horrific climax of a pattern that we know to be true when it comes to domestic violence: notable triggering factors for the husband’s actions in this case are concerns about money, food, and the fact that Mrs. K was exercising her personal autonomy—through breastfeeding the baby. We know firstly that domestic violence is rising due to pressures about money amidst the pandemic; secondly, research also shows that male partners who are inclined to violence increase aggression during pregnancy and after birth, and thirdly, we know that jealousy (in this case, about feeding the baby) can be a trigger for men inclined to violence.

While the global community is aware of these factors, limited access to reporting pathways means local organisations weren’t able to shield Mrs. K before the abuse was so great that it required extreme intervention. Her case makes evident that the reporting of incidents of intimate nature, such as sexual assault and domestic violence, necessitates the transfer of Sexual Assault Referral Centres (SARC) from police stations to hospitals.

The Nigerian police force is culturally hyper-masculine and male-dominated, and Nigerians are 20 times more likely to be killed by the police than by terrorists. It is obvious that an aggressive and masculine environment in a conservative cultural setting is not a safe space for vulnerable women to share intimate stories about private parts of their body. In fact, a police station in Nigeria could be the worst place I could think of for a woman to go to seek relief. That’s why I’ve begun reaching out to call for a timely policy shift, nationally, to shift SARCs to hospitals: the hospitals would assume locus as expert witnesses, and bear the formal responsibility for reporting and advising the police on sexual and domestic violence cases. In turn, the idea is that injured women, or women in danger would feel more comfortable seeking treatment about intimate issues than in a police station. They would be treated for their ailments, and hospital staff would assume the responsibility for translating actionable items to the police. Like any crime, the prospect of swift justice, would also serve as a deterrent, and thus a very timely tool in the strategy to effect preventive social behavioural change.

This call to action is about ensuring we have the right systems in place to safeguard and ultimately empower vulnerable women with the public resources we have available. It is said that sexual and gender based violence is within the lived experience of almost half of our women and girls; equipping health personnel with specialist SGBV SARC and mental health training is both prerequisite, and an imperative.

At the Wellbeing Foundation Africa, we have long offered women attending our health facility based Mamacare antenatal and postnatal sessions a safe space, and a curriculum to discuss concerns, and if needed, report their worries. Nigeria’s updated National Gender Policy should take a whole-family, socio-economic and mental health approach to tackling the scourge of domestic violence; and one way we can start is by ensuring the safe haven of refuge, of a kind of solace: a comfortable environment for vulnerable women to give forensic evidence, find relief, and heal. We must do it for Mrs. K.

FROM July 14th, 2020

I thoroughly enjoyed kick-starting the new week by participating at the UN High-level Political Forum side event entitled, "From Page to Action: Accountability for the Furthest Left behind in COVID-19 & Beyond.” The conversation was strong, timely and direct, as well as being a fantastic way to launch the 2020 Report of the UN Secretary-General’s Independent Accountability Panel for Every Woman Every Child. Co-hosted by the Governments of Japan, South Africa, and Georgia and co-organized by the Every Woman Every Child Secretariat, the Independent Accountability Panel (IAP), International Health Partnership for UHC 2030 (UHC2030), and the Partnership for Maternal, Newborn & Child Health (PMNCH), I appreciated the opportunity of knowledge sharing to deepen the efforts and engagement of my organisations, the Wellbeing Foundation Africa, and Wellbeing For Women Youth Voices towards promoting institutional accountability at national, regional and global policy tiers. As we herald the new commitments targeted at mitigating the disruptions of the Sars-Cov2 pandemic in expectation of focused investments, we are once again reminded that the initiation, solution and fiscal appropriations to drive the delivery and accountability of truly accessible health for all must be embraced and fall within the remits of local and national parliaments. Today, and every day, I particularly commend the WHO Partnership for Maternal Newborn And Child Health PMNCH's ongoing strong collaboration with the International Parliamentary Union IPU, as signalled by the Inter-Parliamentary Union's historic first resolution towards Universal Health Coverage in 2019, substantiating global approaches to recordkeeping. I was particularly enthused by contributions from a number of high-level speakers and leading voices for the delivery of Universal Health Coverage, namely, H.E. Mr. Cyril Ramaphosa; President of South Africa; Chairperson of the African Union, Mr. Shinichi Kitaoka; President, Japan International Cooperation Agency JICA, Ms. Joy Phumaphi, Co-Chair, Independent Accountability Panel for Every Woman Every Child, Mr. Elhadj As Sy; Chair of the Board, Kofi Annan Foundation, Ms. Gabriela Cuevas Barron, President, Inter-Parliamentary Union, Dr. Khuất Thị Hải Oanh; Civil Society Engagement Mechanism, UHC2030, Dr. Natalia Kanem, Executive Director, UNFPA, H.E. Mr. Kaha Imnadze; Permanent Representative of Georgia to the UN, H.E. Ms. María Fernanda Espinosa Garcés; Member, UHC Movement Political Advisory Panel, UHC2030, Ms. Evalin Karijo; Project Director, Youth in Action, Amref Health Africa, Mr. Peter MacDougall, Assistant Deputy Minister of Global Issues and Development, Global Affairs Canada, Dr. Tedros Adhanom Ghebreyesus; Director-General, WHO; Chair, H6 Partnership, Rt. Hon. Helen Clark, Former Prime Minister, New Zealand; Board Chair, PMNCH, and of course, Ms. Gillian Tett; Chair of the Editorial Board & Editor-at-Large (US), The Financial Times (Moderator), alongside so many EWEC partners and frontline organisations. But as the COVID-19 pandemic’s grip on the world shows no immediate signs of loosening, organisations must therefore acclimatise effectively, by integrating the dual-mindset towards technology, in equipping their workforces and ensuring that the dissemination of information – particularly pertaining to health - remains both accurate and accessible. By making this part of an ongoing global transition a priority, we will see to it that society’s most vulnerable individuals are able to continue accessing the information and services which remain a key component in their livelihood. As Nigeria, seeks to mitigate the regrettable and inexcusable reputational damage that recent appalling breaches in cybersecurity have caused, we must also underscore the vital role that technologically supported security platforms play in enabling for remote operations and a continued key health services to be delivered when implemented effectively. Invoking cybersecurity measures have been and continue to constitute a key component in ensuring that accurate health information is circulated worldwide, particularly during this Covid-19 pandemic. We must therefore support all initiatives and efforts in the direction of this construct remaining a top global priority.

FROM July 6th, 2020

For many years, the welcomed priority, purpose and daily-sensitised goal for Women and Girls, Families and Communities - nationally and across our continent as a whole - has been to solidly create, inform, empower and manifest a true demonstration of equality, access and social responsibility regarding their health, their education and the equitable opportunities afforded to assure and improve basic wellbeing, from birth to age. Through the continued collaborative efforts of our nation’s healthcare professionals, researchers, thought-leaders, community volunteers and the service users themselves, Nigeria had long subscribed to the notion of investing in Universal Basic Education. However, the first time that citizens experienced the concrete benefit of an intentional basic or primary public health assistance was in 2018, when Nigeria’s 8th National Assembly appropriated the Basic Health Care Provision Fund – a pinnacle moment in the redemption of the 2001 Abuja Declaration towards achieving Universal Health Coverage. Today, that resounding national applause remains of strong resonance to the Joint Civil Society Organisations Primary Healthcare Revitalisation Support Group to the Eighth National Assembly, which I had chaired. With that being said, a real sense of recurring readiness and receptiveness to campaigns, cultural change and the communication surrounding health and wellbeing as a whole remains palpably evident, statistically proven and collectively celebrated by many – both nationally, and worldwide, and is categorised amongst what still remains a series of promising results acquired through WBFA’s advocacy and partnership efforts with policy-makers and parliamentarians worldwide. In addition, and perhaps more pertinently given the progression of the ongoing COVID-19 pandemic, my morale embodies the significance and importance of global partnership interventions such as that of the Global Financing Facility and the Global Citizen Fund. Their commitment to amplifying the importance of collective efforts in acquiring globally accessible health tools and resources during the pandemic, brings us all one step closer to the concept of continuity of services becoming a very possible reality. As, the Global Financing Facility announced its predictions last week, it conveyed a new set of commitments aimed at mitigating the disruption of services to a number of the countries and global communities most in need. GFF forecasts a possible 18% increase in child mortality, and a 9% increase in maternal mortality across Nigeria over the next year as a direct result of essential health services becoming fragmented during this COVID-19 pandemic. We had only recently learnt the surprising news that Nigeria's 9th National Assembly had predicted a reduction in the value of the primary healthcare and basic education budgets, which as unaddressed to date – reflect as cuts. However, as 30th June marked the International Day of Parliamentarianism, I was also caused to reflect upon the OECD’s interpretations of the role of parliaments during the COVID-19 crisis.  The COVID-19 pandemic is posing threats not only to human health and life, but also to people’s socio-economic well-being and countries’ economic growth. According to the OECD, the global economy is currently suffering its deepest recession since the Great Depression in the 1930s. One of the many visible issues of the current pandemic is the rampant unemployment and loss of income. As well as the increase in poverty, it could impede people from accessing basic services due to unaffordability and inaccessibility. It is estimated that 2.9-5.2 million people could lose their jobs in Indonesia as a result of this global health crisis. Clearly the pandemic is heightening inequality and inequity among citizens as well as within the countries themselves. Yet, presently, the role of parliament is more relevant today than it has been ever before. Parliaments can propose and adopt necessary laws to assist their respective governments in intercepting and tackling COVID-19 and its adverse impacts. Further, parliaments can oversee the expenditure of the public funds related to COVID-19. It is crucial to ensure that the funds are allocated appropriately, and that all individuals receive fair distribution of strategically proposed COVID-19 containment measures. In responding to the COVID-19 crisis, parliaments in Nigeria, and around the world have also established designated Task Forces for COVID-19, aiming to provide assistance and support in the form of medical equipment and personal protective equipment to hospitals and community health centres, in a globally observed and commended response. Every state has different capacities and resources to counter the challenges, whether it is providing and maintaining optimal and accessible healthcare, upholding a functioning and thriving society or managing the state of the global economic. Therefore, international co-operation is imperative, in order to ensure that states - especially within low- to middle-income countries, are able to thrive in this moment of crisis, and eliminate their obstacles in tackling COVID-19. Not surprisingly, three weeks ago, I had joined a high-level discussion on how the ongoing COVID-19 pandemic perpetuates the pressing need to implement Universal Health Care. In welcoming the Africa Leads UHC One By One 2030 Report, and in the new Unite For Action global commitments, I fully agreed that primary health care must cover the breadth of the journey from hospital to hut in communities, and improve the social determinants of all those living and working therein. We should not wait to improve the situation until, God forbid, the next crisis occurs. We have to ensure that our nations’ socio-economic development would not leave anyone behind, as envisaged by the 2030 Agenda. In that regard, every decision, law and regulation made must also be based on principles of equality, participation, non-discrimination, accountability and transparency. I have urged all African Leaders to reinforce and reconfigure their commitments to the 2001 Abuja Declarations in order to exceed the minimum pledged 15% of respective Consolidated Revenue Funds, if we are indeed to fulfil our mantra’s of Africa Rising – to match these global commitments with clear manifestation of a sense and purpose, of evidenced intention, to put our people first, justifying continued global partnerships and multi-lateral assistance. As we face the prospect of reinstating routine primary health and education services that were so destructively interrupted by the coronavirus pandemic, it is clear that Africa needs to factor in the replenishment and reinforcement of investments in both primary health care, and primary education. In doing so, they will build resilience to emerge from the pandemic in a stronger position than before. We must ensure that our weakest frontline services can deliver a healthier, better and stronger educated future for all. As we herald the new commitments targeted at mitigating the disruptions of the Sars-Cov2 pandemic, in expectation of focused investments we are reminded then, that the initiation, solution and budgetary injection must primarily derive from the pots that sit within local parliaments, while recalling that in fact, in 2019, the Inter-Parliamentary Union did actively play its part in passing its historic first resolution towards universal health coverage, substantiating global approaches to recordkeeping. Parliaments themselves should also intensify this co-operation and share their best practices, experiences and challenges in dealing with the COVID-19. International organisations such as the OECD and its Global Parliamentary Network have a pivotal role to play during these unprecedented times. They help to facilitate pertinent policy dialogues on important socio-economic matters and provide us with advice and recommendations, so that parliaments can use them as guidelines to improve the situation and/or propose to its governments. To use the example of the Indonesian Parliament view that the implementation and achievement of the Sustainable Development Goals (SDGs) cannot be postponed amid the COVID-19 pandemic, I restate the fact that the SDGs should be the measure for parliaments to prevent trade-offs in this moment of crisis, for example, between the economy and health, in any laws or programmes. It is also important to emphasise that the entire Indonesian House of Representatives, including those in the commissions, are working to support the implementation and achievement of the SDGs, supporting resolutions relevant to SDGs and that are in the public interest. This is also the time for us as Nigerians, and as Africans, to open our eyes and realise the importance of improving individuals' social and economic rights – especially the poor and vulnerable – such as clean water and sanitation (SDG 6) and economic growth tied to decent work (SDG 8). It is clear that fighting COVID-19 requires people to have clean water and sanitation – and not everyone has access to it. Much of our nation’s willingness to learn, embrace and engage with the plethora of ongoing initiatives that have so positively contributed to the building and delivery of timely, appropriate and affordable care concepts and pathways in Nigeria today, is arguably attributable to the overarching and consistent primary theme of ‘accessibility’ these tremendous efforts were primarily built upon. A fearlessly competent, responsible and promising generation have successfully ensured that accessibility remains a true ethos and the pertinent undercurrent when shaping and delivering an intentional and undeniably imperative standard of care. Sadly, their efforts have now rather tragically arrived at a potential point of trepidation. These findings should fill every stakeholder with encouraging zeal, renewed passion and an inexplicable sense of determination to work towards establishing tangible, long-term solutions for this pandemic and beyond.  We must continue forward – and ensure that a path towards the sustainable replenishment of much needed resources is assured. To date, the responses and levels of engagement from members of society coupled with repeated statistical confirmations of increased success following the introduction of a number of health and wellbeing initiatives, further echoes my sentiments and of many others. Now more than ever before, the nation requires a firm continuation of a well-functioning, culturally and economically appropriate primary health and basic education system – one which must remain accessible to all and for all, in all its entirety. With this being said then, the most poignant way of ensuring that this can and should be made possible, is to maintain the level of financial input that 9th NASS initially committed to and maintained in the lead up to this unfortunate outcome. In light of the recent COVID-19 outbreak, and while duly and empathetically acknowledging the economical setbacks that such a global pandemic has birthed, it is with the greatest of respect, care, honour, but also pride for all that we as a nation have achieved, that I make mention of this decision being a very important one. From our global counterparts and stakeholders, right through to a growing community of invested and daily-committed healthcare and education facilitators here in our nation of Nigeria, the transitions and great strides made and being reflected by way of national and international policy, practice and (societal) position are going from strength to strength. Many of you have responsibly embarked on a lifelong journey which has continuously proven to be of great societal, medical and generational benefit. This is particularly evident statistically. With health, as with education, the access to upholding and maintaining it, and human engagement really do go hand in hand: the intentional attitude and efforts our nation employs daily in a bid to truly care, educate and continue advocating for a significantly positive quality of life for all, is in actual fact, entirely dependent on the resources being made available to professionals and those within their care. Access to affordable healthcare and education then, should be a precise and continuous embodiment of the primary intention behind the service and its delivery. I believe that the truest way in which we can continue to facilitate, impact and inform attitudes and approaches to healthcare and education in our nation, in a way that evidently works well, is to truly uphold our level of (physical and financial) input. Only then, can we truly make it holistically accessible. Last week, I signed my name to join the #GlobalGoalUnite call for urgent investments and actions. Join me, by signing the campaign here, too: www.globalcitizen.org  

FROM June 20th, 2020

There are more displaced peoples in Nigeria—over two million—than the populations of Ilorin, Abuja and even Benin City. The scale of this situation in Nigeria is a tragedy for our people and our economy. At home in Nigeria, the conditions being faced by our population of concern are an increased cause for alarm and focused action within our COVID-19 response strategies – Nigeria is facing immense humanitarian and protection challenges due to the ongoing insurgency in the North East. The conflict has caused grave human rights violations, impacting particularly on the most vulnerable civilians. According to the UNHCR, as of May 2020, there are 2,046,604 internally displaced persons in the Northeast region, with 90% of the displacements in Borno, Adamawa and Yobe states. Outside of the Northeast an estimated 578,119 people are displaced due to banditry and farmer-herders conflict. There are 61,361 registered refugees and asylum seekers as of April 2020, with 60% located in Cross Rivers, 21% in Taraba, 12% in Benue and 6% registered in Lagos whom are classified as urban refugees and asylum seekers. There are a further 292,513 Nigerian Refugees in our neighbouring countries of Niger (55%), Cameroon (40%), and Chad (5%). View the map>> In summary, as of May this year, the total number of people attributed to Nigeria’s existing population of concern stood at 2,107,965. More than 61,000 were registered as refugees and asylum seekers, and the significant remainder originating from neighbouring nations were identified as internally displaced persons (IDP). The spectrum of challenges that refugees and displaced persons face is very broad: they may be traumatised, having lost homes, livelihoods and identities. However, when the host communities have strong systems in place, the suffering is mitigated, and the road to recovery can begin. I have always felt that refugees should have health rights guaranteed in any host location, and health-enhanced certifiable identities. The United Kingdom, Greece and Turkey support the health of refugees effectively, with the help of the World Health Organisation, which works closely with government health departments to provide culturally and linguistically sensitive health services to refugees. That’s why in February I was pleased to attend the launch of the Lancet Migration, a collaboration of researchers in migration and health who are building evidence to drive policy change in this area. I’ve been involved with helping to provide aid to many refugee camps in Northern Nigeria, and I’ve come to the understanding that ensuring health care should be standard in supporting the dignity of displaced persona. On World Refugee Day today, I commit to working with Lancet Migration, and call for attention on the rights of refugees in relation to accessibility to health care.

FROM June 1st, 2020

This year marked the start of the United Nations' Decade of Delivery, where we were promised that things would change for the empowerment of women and girls. Armed with research to prove how much better off our world would be with the rights of women and girls realised, we in the global advocacy community declared that it is well past time to start living in a gender equal reality.

But instead of keeping our promise to protect and empower women and girls, in Nigeria in 2020, we are still burying them.

Vera Uwaila “Uwa” Omozuwa was a 22-year-old student at the University of Benin who went to her church to read in a quiet space when she was brutally raped. The viral photos of her bludgeoned body have reverberated around the world, adding fire to the flames of the conversation about brutality, violence and lack of a framework for social justice and responsibility; she died of her injuries on 30 May. In Lagos, 16-year-old Tina Ezekwe was trying to get on a bus when a drunken, corrupt police officer attempted to bribe the driver, leading to a sloppy confrontation and shots fired: the bullet pierced through the upper left side of her lap. The battle to save her life lasted for two days, and she died on 28 May. In Jigawa, Jennifer, a twelve year old girl was allegedly raped by 11 men, who have been arrested. In 2018, promising young girls Anita Akapson and Linda Angela Agwetu were murdered in similar, senseless fashion, again by trigger-happy officers around their own homes. These cases spotlight what has been blindingly evident since the forced abductions of the Chibok and Dapchi Schoolgirls: we are failing our women and girls. Last year I was honoured to join the International Conference on Population and Development, full of hope to deepen Nigeria’s consultations on gender. I called to build political commitment from leaders and policymakers to speak out, condemning violence against women. But with the heartless, thoughtless violent deaths of Uwa and Tina it is clear that we have thus far failed to engage leaders and policymakers to implement meaningful mechanisms to protect them. I had declared in 2018, after the death of another innocent girl victim of sexual and gender based violence, Ochanya,  that we were standing on a gender precipice from where good actions could flow, if together, we determinedly took the right actions to protect women and girls. I declared that I envisaged a world where everyone can decide freely when to have children, and has the information, education and means to do so. With sexual and reproductive health care deemed “non-essential” during the COVID-19 pandemic, and consequent restrictions implemented all over the world, we have failed to protect women’s rights to her own body. At the United Kingdom-France consultations on the Prevention of Sexual Violence Initiative last year, we said with such hope that we would uphold the United Nations Security Council's Resolution 1325 on women peace and security. While at the African Women Leadership Network and the African Union with UNWomen last year, we vowed to invest in women's groups, to ensure that we give women the leadership opportunities to better shape their own futures, and we did. But when globally, only 1% of gender equality funding is going to women's groups, we have failed to invest in women. At the Commonwealth of Nations last year, we made a promise of No More Violence, yet, here we are, from our leaders, and right down to our grassroots, failing women and girls. Frankly, I am outraged. The gruesome deaths of Uwa and Tina are a visceral notice of our failure in Nigeria, and that’s why I am joining the WACOL Tamar SARC and Social Intervention Advocacy Foundation to call for radical reform of our police, to end the impunity of sexual violence against women and girls. In the name of all our global and national commitments to women and girls, the Nigerian state must make systemic changes to protect our young girls. Uwa and Tina’s lives will not be lost in vain. Join the cause>>

FROM May 29th, 2020

The recent stories about violent police killings of African Americans are pulling at my heartstrings. My expertise is in child and maternal health and wellbeing in Africa, and police brutality in the United States may seem like it is 6,218 miles (the distance from Lagos to Minneapolis) away from my wheelhouse. But that would be denying the reality that we Africans are a global community united by the colour of our skin and ancestries that have been altered by systems of oppression that have spanned and scrambled our societies for generations, and which we have, collectively and individually, climbed to overcome.

I care for mothers and children in Nigeria and Africa because when maternal mortality is so high and when we see black people dying of COVID-19 at a far higher rate than white people, it is of existential importance to nurture the forthcoming generations of our people. As Ta-Nehisi Coates once wrote, black people love their children with a kind of obsession, because black children are endangered.

The video of George Floyd, pleading for his life from under the knee of a casual police officer; the story about the EMT nurse Breonna Taylor, shot a shocking eight times after a misunderstanding; that Ahmaud Arbery was practically hunted by mistaken neighbours while out for a jog is a stark reminder of our peoples' endangerment. With all of its power and functioning bureaucracies, the U.S. —held up as the pillar of democratic practice globally—has the means, the wherewithal, and the opportunity to signal to the world that it values black lives. I am given an ounce of relief in the fact that the U.S. Justice Department said it would make a federal investigation into Mr. Floyd's death a "top priority." However more must be done through education, investment and empowerment. In the face of mounting police brutality in my own country, in 2019, I encouraged the youth-led END SARS Movement in Nigeria, initiated by the Social Intervention Advocacy Foundation. Their aim was to establish much-needed partnerships between the key security agencies, academia and industry practitioners for research-based solutions. They have advocated for operational and governance models to be developed—to put a stop to extrajudicial killings of young people. Since then, some best practices have been adopted and shared, as well as SIAF joining a national security cooperation in support of peace and stability. The work continues as they liaise with national government security agencies and to facilitate them in improving operational standards and good governance, and as they help to maintain a peaceful and tranquil society. Riots are not an answer - to enable change, stakeholders know that they must constantly undertake methodical studies of endemic and emergent problems in the principles and practices of law enforcement policing, intelligence operations, maintaining homeland security, transnational security and trafficking, corruption and the criminal justice system and promotion of science and technology. Reformation in correctional services and forensic sciences, being an integral part of the justice system, must also be researched thoroughly. We as Africans and African diaspora must work to instil the understanding that soft phrases such as 'race relations' oftentimes hide the fact that racism for so many of us is corporal. The failure of health systems to protect and cure people of black and minority ethnicities around the world means that racism does manifest through organ failure via COVID-19. The failure of police hierarchies to ensure its ranks are careful, and the failure of education systems to teach its pupils about other cultures is manifested through bodies bleeding out from gunshots. Some are calling for African leaders to summon their local US ambassadors to speak out against these injustices, and in the name of our community, I join in that call. We must unite our global African community around these lost souls, who have been killed extra-judicially, to proclaim the might and meaning of human rights and social significance of our people.

FROM May 26th, 2020

As we mark Africa Day, I am encouraged by the milestones we have achieved, standing together as one united Africa, towards providing equity in health access since the Alma Ata declaration of 1978.⁣ ⁣ Personally, a high point for Nigeria was in 2018 when Nigeria's National Assembly, chaired by my husband H.E. Dr Bukola Saraki MBBS, CON, helped establish the Basic Health Care Provision Fund. It was a key and catalytic step towards achieving Universal Health Coverage for our citizens.⁣ ⁣ As the coronavirus pandemic puts health systems to unprecedented tests, I call on our African leaders, of governments, of policies, and of innovative actions, to rise to the challenge of the #AfricaWeWant. We must accelerate investments and actions to meet the health needs of our citizens by strengthening primary health care services with efficient diagnostics, referrals and treatment. Let's walk the talk for primary health care and wellbeing.⁣ ⁣ As we stand together in rallying the right resources to combat COVID-19, I also call for the reinforcement and replenishment of the 2001 Abuja Declaration—a pledge made by the African Union, standing as one, promising to increase their health budget to at least 15% of the state's annual budget. The World Health Organisation reported in 2010 that only one African country had reached that target. Today in 2020, we must replenish and reinforce those promises to ensure that every citizen can access an efficient system of quality health.

FROM May 20th, 2020

During a normal year I would be traveling to the World Health Assembly this week, but this year I joined state leaders and world-renowned experts virtually from our homes, in light of the COVID-19 pandemic. Still, the spirit is evident: global collaboration on the state of our world’s health has never in our lifetime been more necessary.

During this week's World Health Assembly, I am calling on global leaders, particularly in Nigeria and across Africa, to make commitments to rebuild and reinforce every element of primary health care.

  This is backed by the decades I have worked on maternal, child and family health throughout Nigeria. Primary Health Centres (PHCs) are mostly located within communities, and much of Nigeria and Africa remains rural. With the majority of Nigeria’s population living in these rural communities, and a recognition of the strong indications of community transmission of the virus, PHCs should serve as an important link in the management of the COVID-19. In 2015, I successfully facilitated a maternity referral standard primary health centre at Eruku Cottage Hospital in Kwara State, and saw the benefits of a prompt pathway from diagnostics to treatment and care.⁣   [video width="640" height="360" mp4="https://toyinsaraki.org/wp-content/uploads/2020/05/2e03506b-bae4-4210-a566-fe2f122bbc54.mp4" autoplay="true"][/video]   Similarly, from my leadership role chairing Nigeria's Civil Society Coalition's Primary Health Care Revitalization Support Group to the 8th National Assembly, which successfully advocated for the Basic Health Care Provision Fund, I know that achieving universal health coverage will not rest upon one single static action, but on the spectrum of interventions and initiatives; from water, sanitation and hygiene standards in healthcare facilities to breastfeeding education and training for healthcare workers. In a country as large as Nigeria, resilience throughout the whole nation’s system was always going to be necessary if we were going to be able to tackle critical health emergencies in fragile settings, such as in the North East. Today, even the strongest regions are sorely tested, and that is why a strengthened primary health care system is imperative as the foundation to achieve health for all. Support for PHCs should be a focal point for investment, as we coordinate our responses to the pandemic. It is only by strengthening capacity and concrete frameworks at primary levels of care and education services that we can build the resilience to cope in times of crisis, restore health and prosperity, create healthy futures and improve the wellbeing of citizens in the long-term. Read more on Wellbeing Foundation Africa>>

FROM May 8th, 2020

I am excited to announce that Wellbeing Foundation Africa is partnering with U.S.-based company Fortify to address iron deficiency: the major underlying cause of maternal deaths during childbirth in developing countries. ⁣ I started working on improving iron deficiency in Nigeria in 2014 with a programme called Green Food Steps. I worked with Unilever’s biggest brand Knorr to educate women and daughters to practice new, nutritious cooking habits. ⁣ But when I met the Fortify team to talk about a partnership last year, I was struck by how elegant yet practical a solution they have for iron deficiency anemia: they help add iron to ingredients that make up everyday meals—such as tomato paste. Tomato paste is already built into the food supply, it’s a big part of the meals every African eats; that’s why they’ve worked to produce 20 million sachets of iron-fortified tomato paste varieties in Nigeria monthly. Implementing more iron in our food staples is not just a compassionate move to improve maternal health: it’s economically beneficial, too. According to the World Health Organization, timely treatment of iron deficiency anemia can ultimately raise national productivity levels by as much as 20%. ⁣ That’s why I’m so excited to engage First Ladies and women leaders—because of the impact they bring to women, families and communities in improving maternal health outcomes—but also policymakers across Africa to accelerate efforts to eradicate iron deficiency. Read more on Wellbeing Africa. 

FROM May 4th, 2020

Toyin Saraki hails midwifery professionals as the world marks International Day of the Midwife 2020; Launches ‘We Must Applaud Midwives with WASH’ campaign

Toyin Saraki has hailed International Day of the Midwife, marked today around the globe, as “the most momentous day in a century for midwives.” Saraki, who is Global Goodwill Ambassador for the International Confederation of Midwives (ICM) and Founder-President of the Wellbeing Foundation Africa (WBFA), has marked the day by paying tribute to midwives around the world and by launching a new campaign to improve the safety of their working conditions. Saraki commented: “2020’s International Day of The Midwife is remarkable in many respects – and is truly momentous, as it takes place in the first ever Year of the Nurse and the Midwife. This year has been designated by the World Health Organization as a year-long effort to celebrate the work of midwives and their colleagues, highlight the challenging conditions they often face, and advocate for increased investments in the workforce.” “While we celebrate the work of midwives, this is also a solemn day, as we pay tribute to midwives who have lost their lives in the course of their duties, not only during the current COVID-19 crisis but also those in recent years who have paid the ultimate price in conflict areas. Whatever the circumstances, however dangerous, midwives continue to provide a continuum of care, standing beside women at their most vulnerable moments. I know that I will have many midwives, including close friends, in my prayers today.” “Infection prevention and control is at the top of the global agenda right now. Midwives have led on this since 1840 – if not before – when physician Ignaz Semmelweis worked with midwives to promote water, sanitation and hygiene (WASH) on maternity wards. I am therefore proud today to launch the ‘We Must Applaud Midwives with WASH’ campaign, to highlight that whilst we should applaud midwives we also need to ensure that they have the conditions they need to work safely and deliver for women, babies and communities. WASH plays a vital role in stopping disease transmission yet two out of five healthcare facilities still lack hand hygiene facilities at points of care. I am promoting ten immediate actions which should take place in all healthcare facilities to respond to COVID-19 and protect midwives, their colleagues and patients.” “Midwives are champions of women’s rights; but can only be effective if their rights are also secure. This includes the right for every midwife—and all health workers—to decent work and a safe and dignified workplace. Saving lives does not mean a midwife should risk her own. I continue to advocate for whole-system support, which means providing midwives with the adequate tools, equipment, and medicine to provide the full scope of timely, high-quality care, and the capacity to carry out the WHO-recommended 8 antenatal visits. We should all take up the call of the International Confederation of Midwives to celebrate, demonstrate, mobilise and unite with midwives.” Toyin Saraki is also Special Advisor to the World Health Organization Independent Advisory Group to the Regional Office for Africa, a member of the Concordia Leadership Council and was named by Devex as ‘Global Health for All Champion. Toyin Saraki is promoting the following ten Immediate WASH Actions in Healthcare facilities to Respond to COVID-19: 1. Handwashing: Set up handwashing facilities, like a bucket with a tap with soap, throughout the facility. Prioritise the facility entrance, points of care and toilets, as well as patient waiting areas (and other places where patients congregate). If the facility is piped, repair any broken taps, sinks or pipes. 2. Water Storage: Consider the water requirements to perform WASH/IPC activities with an increased patient load. If inconsistent or inadequate water supply is a concern, increase the water storage capacity of the facility, such as by installing 10,000L plastic storage tanks. 3. Supplies: Solidify supply chains for consumable resources, including: soap (bar or liquid), drying towels, hand sanitiser and disinfectant. Ensure cleaners have Personal Protective Equipment (PPE) for cleaning. If ingredients are available locally, produce hand sanitiser at the facility (or at district-level) – see WHO protocols. 4. Cleaning & Disinfecting: Review daily protocols, verifying based on national guidelines or global recommendations for resource-limited settings and noting additional levels and frequency of cleaning in clinical areas with high numbers of COVID-19 cases, including terminal cleaning. Ensure adequate supplies of cleaning fluids and equipment, making allowance for additional cleaning requirements. Ensure handwashing stations and toilet facilities are cleaned frequently. 5. Healthcare Waste Management: Strengthen healthcare waste management protocols by making sure bins are located at all points of care, that they are routinely emptied, and waste is stored safely. 6. Staff Focal Points: Assign staff member(s) – cleaners, maintenance staff, or clinicians -- whose job it is to oversee WASH at the facility, including: refilling handwashing stations, auditing availability of supplies in wards, reporting on WASH maintenance issues, monitoring cleaning and handwashing behaviours of staff and communicating updates to the director daily. 7. Training: Organise training for all staff on WASH as it relates to their role at the facility, including a specific training for cleaners based on the protocols reviewed above. 8. Daily Reminders: Remind staff of WASH protocols during morning meetings. Post hygiene promotion materials throughout the facility, particularly next to handwashing facilities. 9. Hygiene Culture: Encourage a culture of hygiene at the facility. Emphasise that all staff members, including cleaners and maintenance staff, are part of a team working to prevent the spread of infection. Recognise individual WASH champions in the HCF. 10. IPC Team: Work with the Infection Prevention and Control (IPC) team at the facility to make sure efforts are reinforced and aligned, avoiding duplication. Encourage WASH focal points/partners to participate in IPC meetings. Coordinate WASH/IPC activities based on plans to isolate COVID-19 patients. More on International Day of the Midwife can be

FROM April 28th, 2020

Together, we are facing a global health crisis. Each day, as the death toll due to COVID-19 rises, people in governments, institutions, hospitals, communities and households around the world are having to navigate unprecedented sacrifice and hardship – making decisions with profound effects on their lives and livelihoods. As a collective network of girls, women, advocates, and allies working in global development, we stand together to encourage global collaboration to combat COVID-19. Only by working together can we ensure that no one is left behind in our response to the pandemic. Our focus now must be on supporting vulnerable communities and the most vulnerable people within our communities – in the spirit of solidarity, but also for our own protection. This includes girls and women who are now at a higher risk of gender-based violence and rights abuses, and at-risk groups (including people who have disabilities or identify as LGBTQIA) who are being targeted or are unable to access routine services. At a time of ever-increasing social distancing, there has never been a more crucial need for community and selfless leadership. The World Health Organization’s continued focus on saving lives and supporting and protecting the most vulnerable of us will play a pivotal role in our recovery. Now more than ever, countries need to unite behind a strong WHO – sharing knowledge, strategy, technical resources and financial investment to defeat the global threat we all face. We must make no concessions for blame, politicisation or racism in developing an inclusive and effective solution to this crisis. Across the world, we see the power of community and shared resources, as individuals step forward to support each other. Our heroes – the predominantly-female health workforce, working day and night to serve our communities and unite us – have demonstrated that cooperation is to mitigate the impact of COVID-19. In such challenging times, it is crucial that we overcome any efforts to divide us. Join us by signing on

FROM April 15th, 2020

For better health security, it's time to end gender biases that keep women out of global health leadership positions

Whenever a high-profile health emergency breaks out or an influential commission needs experts, it seems global health reverts to the default of delivered by women, led by men. The message seems to be Health emergency! Step aside, ladies – men coming through. Although women make up 70 percent of the global health workforce, and although they work at all levels in health security—from the front lines of healthcare, to research labs, to health policy circles – they have not been represented equally in decision-making bodies that are informing our COVID-19 responses. A presidential tweet showed the first iteration of the U.S. Coronavirus Task Force was composed entirely of men. In January, just five women were invited to join the twenty-one member WHO Emergency Committee on the novel coronavirus. Unrelated to this decision, UN Secretary General Antonio Guterres made a strong public statement a few weeks later. "Women’s inequality should shame us all. Because it is not only unacceptable; it is stupid," Guterres said in February. "Only through the equal participation of women can we benefit from the intelligence, expertise and insights of all of humanity."
[caption id="attachment_1085" align="aligncenter" width="640"] UN Secretary-General Antonio Guterres at a press briefing on the eve of an International Conference on the future of 4.6 million Afghan refugees living in Pakistan—in Islamabad on February 16, 2020. REUTERS/Saiyna Bashir[/caption]
There is a huge contingency of global health experts who are also women, but they are not being called upon to lead responses to this global health emergencyand this puts us all at risk. Ignoring women’s expertise and perspectives undermines health security for everyone.

Six reasons why gender matters in global health security:

NUMBER ONE: Strong COVID-19 responses draw leaders from the entire talent pool. Women are 70 percent of the global health workforce but hold only 25 percent of senior decision-making roles. Excluding women from decision making robs health systems of the knowledge and expertise of the health workers who know these systems best. In America, which has a mostly-male Coronavirus Task Force, women have become the majority of young doctors and epidemiologists. Including women (and women from diverse groups and geographies) is about effectiveness and saving lives, not just representation. Diverse leadership groups make better, more informed decisions. NUMBER TWO: Women are needed to fill the global shortage of health workers, which limits our ability to respond to health emergencies. As the majority of the global health and social workforce, women currently deliver health care to around five billion people. Female health workers are central to the response to any epidemic. The women health workers on the front lines of health systems do not want to be sentimentalized or celebrated as martyrs. They want to lead, they want to be listened to and they want the means to do their jobs professionally, safely and with dignity. Around half of all health workers are nurses and midwives. As the International Year of the Nurse and the Midwife, what better time than 2020 to harness the expertise and leadership potential of nurses and midwives? A 2019 WHO report concluded, however, that although women are the majority in the health and social workforce, they are clustered into lower status, lower-paid (and unpaid) roles and frequently subject to discrimination, bias and sexual harassment, which can cause them harm, limit their career growth, and cause attrition. With a projected global shortage of around forty million health and social workers by 2030—eighteen million needed in vulnerable low-income countries alone—the world must invest urgently in decent work for female health workers and enable them to fulfil their potential in all areas, including leadership. That is our best chance of retaining female health workers and scaling up the global health workforce to meet demand and the challenges of epidemics and pandemics. NUMBER THREE: Women’s political voices strengthen health systems for better health security—now and in the future. Women do not have an equal say at political level in most countries on critical issues like health budgets and universal health coverage. Globally, women are only 24 percent of the parliamentarians who make decisions on health systems funding and coverage. If women did have an equal say in political decisions on health, research suggests health systems would be stronger as female parliamentarians are more likely to give [PDF] greater priority to health. This matters now more than ever; countries with strong national health systems and universal health coverage are better able to cope with outbreaks and other health emergencies. Without strong health systems that make care affordable and accessible, the most vulnerable—older people, pregnant women, the homeless, the poor, and those with pre-existing conditions and poor health status (the majority of whom are women)—will be missed by critical outbreak response activities such as widespread testing and treatment. Ultimately, this hinders containment of infectious diseases like COVID-19.
‘Countries with strong national health systems and universal health coverage are better able to cope with outbreaks and other health emergencies’
[caption id="attachment_1086" align="aligncenter" width="640"] Afghan parliamentary candidate Suhaila Sahar during an election campaign in Kabul on October 8, 2018. Research suggests female parliamentarians are more likely to give greater priority to health. REUTERS/Omar Sobhani[/caption] NUMBER FOUR: Women and men have different, socially defined roles—and this perpetuates inequalities and weakens health security. Women carry out the majority of care for sick family and community members, and that puts women at greater risk of contracting infections like COVID-19. At the same time, women’s role as household caregivers can be leveraged for better health promotion and disease prevention/management at the family and community levels—but only if they are empowered with accurate information and the means to support the sick. COVID-19 was initially associated with a particular food market in Wuhan, China, where it is likely that the majority of traders were women. After the SARS outbreak in China in 2002, women in the same professions could have been vital allies in the cultural and behavioral change needed to avert a new viral outbreak—but clearly, this opportunity was missed. In many country contexts women are less educated than men, have less access to digital technology, and are generally overlooked as potential change agents. NUMBER FIVE: Biology and gender determinants of health affect the way disease is transmitted and progresses. Data are still being collected and analysed, but early figures from the COVID-19 outbreak in China show higher mortality among men than women, especially in older age groups.
‘Early figures from the COVID-19 outbreak in China show higher mortality among men than women, especially in older age groups’
One hypothesis is that higher smoking rates by men leaves them more susceptible to respiratory viruses like SARS-CoV-2, which causes COVID-19. There are other gender-related aspects of the disease that are virtually unknown—for example, we still need to understand how COVID-19 affects pregnant and breastfeeding women in order to protect both women and the unborn child. A different virus, Zika, if contracted by a pregnant woman, does serious harm to the unborn child. Nothing similar has been reported with COVID-19, but this example show that it is critical that policy responses to epidemics examine the impact of both biological sex and the gender determinants of health. [caption id="attachment_1087" align="aligncenter" width="640"] A man wearing an N95 mask smokes in Singapore on February 23, 2020. Higher smoking rates among men may leave them more susceptible to respiratory viruses and account for higher COVID-19 mortality. REUTERS/Feline Lim[/caption]
 
NUMBER SIX: Global health rests on the foundation of women’s unpaid work. Here’s an uncomfortable fact: women in health contribute an estimated 5 percent to global GDP ($3 trillion), of which almost 50 percent is unrecognised and unpaid. Some of the world’s poorest women and girls are effectively subsidising health systems and missing out on opportunities to enter education and the formal labor market. This is not only inequitable—it weakens global health security everywhere. Infectious diseases like COVID-19 do not respect national borders, and we are all only as safe as people in the weakest national health system. Women’s unpaid work needs to be recorded, redistributed (within the family and community) and rewarded, with women enabled to transition into paid formal sector employment.
‘We cannot fight a global health challenge like this by drawing from just half the talent pool’
This week, Women in Global Health was proud to launch COVID 50/50, our campaign for a more inclusive pandemic responses, which includes fives asks for more gender-responsive health security. These asks build on Operation 50/50—a crowdsourced list of women health security experts, designed to be a resource for organizations looking for health security experts and media commentary on COVID-19. The current pandemic makes it clear: it’s time to acknowledge that the gender stereotypes and bias keeping women out of leadership and decision making put us all at risk. We cannot fight a global health challenge like this by drawing from just half the talent pool. We cannot win this fight with one hand tied behind our backs.

FROM April 15th, 2020

The world is hurting, and we need the WHO now more than ever before. Millions are suffering and misinformation is spreading, with fear and even racism impeding mechanisms for an effective response. Countries and communities are acting both together and apart. Right now, every community needs information based strictly in science and supported with the benefit of a global perspective. The world needs a well-functioning global organization designed to facilitate international coordination. We need the WHO, our standard-bearer in unprecedented times for an unprecedented virus. The pandemic is a stark reminder that humans are connected, and that what happens in one country can impact the everyday lives, social fabrics and economies of countries far away. Human connectivity holds power: the positive impact of our collective will to physically distance from one another alone shows what power we hold. Guided by the heart beat of world health—the WHO—together we have pulled resources, research, and we have made a global effort to benefit the health of all of us. We are grateful for those who have recovered due to the efforts of indefatigable health workers who have detected, tracked, traced and treated the affected, even as we have mourned the lives and livelihoods that we have lost. Together we must continue to marshal support to combat this virus. We hold the hope for better days ahead.

FROM March 25th, 2020

World Tuberculosis Day 2020 – It Is Crucial To Deepen TB Advocacy And Actions To Ensure Tuberculosis Does Not Become Totally Invisible During The COVID-19 Pandemic – Toyin Saraki, Founder, Wellbeing Foundation Africa I was recently following the research findings of Madhukar Pai, Canada Research Chair of Epidemiology and Global Health at McGill University, Montreal Canada, where he called for a damage control plan for tuberculosis during the ongoing COVID-19 Pandemic. As the coronavirus COVID-19 pandemic sweeps the world, the global health community working to fight TB have growing anxiety about what this pandemic will do to a much older infectious killer - tuberculosis (TB). We know from the Ebola experience that epidemics can disrupt even basic services such as routine immunization. No doubt, COVID-19 will adversely affect all routine health services everywhere. But TB services is might be one of the biggest casualties. Why? Even before COVID-19, TB had a notorious track record as a ‘Captain of the Men of Death’. TB kills 4000 people each day, and 1.5 million people each year. TB is the leading killer of people living with HIV/AIDS. An estimated 10 million people developed TB in 2018, and nearly half a million people developed drug-resistant TB (DR-TB). COVID-19 is a crisis of social solidarity and social investment. This applies to TB as well. It is crucial to deepen TB advocacy and actions to make sure TB does not become completely invisible during the COVID-19 pandemic. People are leaving no stone unturned to stop the coronavirus pandemic. If we show even half of this dedication towards ending TB, we can stop millions from dying from a preventable and curable disease. I stand in solidarity with the Stop TB community as we support people affected by COVID-19. This World TB Day we support the fight against the new pandemic, share our lessons, experiences and tools so that united we can defeat it. We want to remind global leaders the urgency to invest in better and more resilient health systems, today more than ever we realise the need to end endemics like TB or COVID-19. To fight COVID19, we can use the tools needed to End TB: infection control, artificial intelligence, x-rays, contact tracing, telemedicine and psycho-social support. Years of under-investment made tuberculosis and its drug resistant forms the biggest infectious disease killer with over 4000 deaths per day. We can’t afford to repeat these mistakes and be unprepared for pandemics like COVID19. Most TB survivors have gone through the isolation, fear, discrimination and stigma that we are facing with COVID 19. Let’s hear their voices and learn resilience from them. It’s Time To End TB. It’s time to recognize that people with #TB are vulnerable to COVID19, including prisoners, migrants, people living with #HIV, and those who are malnourished. Healthcare workers are at the centre of the fight against diseases such as tuberculosis or COVID-19 - While most of us are at home, social distancing, the health workers leave their houses and families to ensure that people with TB get diagnosed, treated and cured and also battle COVID-19. I appreciate and applaud their efforts as frontline health heroes. I join the Stop TB Partnership in calling on global leaders to join forces to protect people affected by TB and especially vulnerable populations from #COVID19. It’s time to ensure we #LeaveNoOneBehind #ItsTimeToEndTB

FROM February 9th, 2020

Along with the global health community, The Wellbeing Foundation Africa has taken note of the WHO declaration of a public health emergency of international concern over the global outbreak of the Novel Coronavirus. WHO has identified 13 top priority countries (Algeria, Angola, Cote d’Ivoire, the Democratic Republic of the Congo, Ethiopia, Ghana, Kenya, Mauritius, Nigeria, South Africa, Tanzania, Uganda, and Zambia) which either have direct links or a high volume of travel to China. “To ensure rapid detection of the novel coronavirus, it is important to have laboratories which can test samples and WHO is supporting countries to improve their testing capacity. Since this is a new virus, there are currently only two referral laboratories in the African region which have the reagents needed to conduct such tests." “However, reagent kits are being shipped to more than 20 other countries in the region, so diagnostic capacity is expected to increase over the coming days. Active screening at airports has been established in a majority of these countries and while they will be WHO first areas of focus, the organization will support all countries in the region in their preparation efforts" "It is critical that countries step up their readiness and in particular put in place effective screening mechanisms at airports and other major points of entry to ensure that the first cases are detected quickly” The Wellbeing Foundation Africa commends and thanks the thousands of courageous frontline heroes, the frontline health professionals who are working around the clock in affected regions to treat the sick, save lives and bring this outbreak under control. The Wellbeing Foundation Africa continues to advocate and urge, particularly in Nigeria which is currently responding to a Lassa Fever outbreak in over 11 states, that investment in a skilled and sustainable, locally led frontline health workforce able to detect, report and respond to threats and deliver quality health services including water, sanitation and hygiene essentials for infection prevention and control, is crucial to building health systems resilient to outbreak.